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J Cosmet Med 2023; 7(1): 49-52
Published online June 30, 2023
Ways of prevention of thread extrusion after insertion of polydioxanone thread for nasal tip projection
Kyoungjin Kang, MD, PhD1 
, Jaeran Hong, PhD2 , Yibeom Shin, MD3
1Shimmian Oculoplasty Clinic, Seoul, Rep. of Korea
2Department of Occupational Therapy, Gwangyang Health College, Gwangyang, Rep. of Korea
3Plushu Clinic, Seoul, Rep. of Korea
Correspondence to :
Kyoungjin Kang
E-mail: safikccs@pascal-world.com
© Korean Society of Korean Cosmetic Surgery & Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cogged polydioxanone (PDO) thread, which is inserted into the blunt cannular, is cosmetically used for non-surgical projection of the nasal tip. However, thread extrusion is a frequently occurring side effect despite the production technology of the thread has improved. To prevent this, we changed the location of the insertion site from the middle of the tip to 0.5 cm above the supratip break point and applied the cannular, which was manually bent about 30°, 1.5 cm from the cannular tip. The bent cannular was located in the supraperichondral layer of the upper lateral cartilages, moved down to middle of the tip, rotated 180°, and the columella inserted inwards to the nasal spine by holding the nose in the desired position of tip projection with the non-dominant hand. For tip projection, 4 threads were inserted. For dorsal augmentation, 1.0 ml hyaluronic acid (HA) filler was injected as a single approach, and both 8 threads and 1.3 ml HA filler were used as a combination approach. The effect was maintained for at least 2 years after the procedure, without any thread extrusion. The patient was greatly satisfied with the natural appearance. This method is an easy and reliable technique for both tip projection and preventing thread extrusion.
Keywords: extrusion, hyaluronic acid filler, nasal augmentation, polydioxanone thread, tip projection
Fig. 1.The insertion technique by turning of the bent cannular. (A) A schematic view of an Elasty V BARDTM polydioxanone (PDO) thread (8.5-cm long) inserted into the blunt cannular (6.5-cm long). (B) The bent cannular as a schematic view of A was placed parallel to the perichondrium of the upper lateral cartilage, moved down to the middle of the nasal tip (1, as a black line). At this moment, it was turned 180° (2, as a white line), and placed in the middle of the columella, until it finally reached each side of the nasal spine of the maxilla (3, as a red line). The orange arrow shows the entry site, and the red arrow shows the moving direction of the cannular.
- Jung GS. Minimally invasive rhinoplasty technique using a hyaluronic acid filler and polydioxanone threads: an effective combination. Facial Plast Surg 2019;35:109-10.
- Jin HR, Kim SJ. Presentation patterns and surgical management of the complications of thread rhinoplasty. Clin Exp Otorhinolaryngol 2022;15:247-53.
- Lee HY, Yang HJ. Rhinoplasty with barbed threads. Plast Reconstr Surg Glob Open 2018;6:e1967.
- Kang SH, Moon SH, Kim HS. Nonsurgical rhinoplasty with polydioxanone threads and fillers. Dermatol Surg 2020;46:664-70.
- Helmy Y. Non-surgical rhinoplasty using filler, botox, and thread remodeling: retro analysis of 332 cases. J Cosmet Laser Ther 2018;20:293-300.
- Chen Y, Hu J, Xing J, Li Y, Xu Y, Li N, et al. Complications following thread rhinoplasty. J Cosmet Dermatol 2022;21:4722-6.
- Kang K, Kim MH, Byeon HS. A case of temporary correction of drooping nose due to postoperative descent of silicone implant using a filler injection. J Cosmet Med 2020;4:41-5.
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How We Do It
J Cosmet Med 2023; 7(1): 49-52
Published online June 30, 2023 https://doi.org/10.25056/JCM.2023.7.1.49
Copyright © Korean Society of Korean Cosmetic Surgery & Medicine.
Ways of prevention of thread extrusion after insertion of polydioxanone thread for nasal tip projection
Kyoungjin Kang, MD, PhD1 , Jaeran Hong, PhD2 , Yibeom Shin, MD3
1Shimmian Oculoplasty Clinic, Seoul, Rep. of Korea
2Department of Occupational Therapy, Gwangyang Health College, Gwangyang, Rep. of Korea
3Plushu Clinic, Seoul, Rep. of Korea
Correspondence to:Kyoungjin Kang
E-mail: safikccs@pascal-world.com
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Cogged polydioxanone (PDO) thread, which is inserted into the blunt cannular, is cosmetically used for non-surgical projection of the nasal tip. However, thread extrusion is a frequently occurring side effect despite the production technology of the thread has improved. To prevent this, we changed the location of the insertion site from the middle of the tip to 0.5 cm above the supratip break point and applied the cannular, which was manually bent about 30°, 1.5 cm from the cannular tip. The bent cannular was located in the supraperichondral layer of the upper lateral cartilages, moved down to middle of the tip, rotated 180°, and the columella inserted inwards to the nasal spine by holding the nose in the desired position of tip projection with the non-dominant hand. For tip projection, 4 threads were inserted. For dorsal augmentation, 1.0 ml hyaluronic acid (HA) filler was injected as a single approach, and both 8 threads and 1.3 ml HA filler were used as a combination approach. The effect was maintained for at least 2 years after the procedure, without any thread extrusion. The patient was greatly satisfied with the natural appearance. This method is an easy and reliable technique for both tip projection and preventing thread extrusion.
Keywords: extrusion, hyaluronic acid filler, nasal augmentation, polydioxanone thread, tip projection
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References
- Jung GS. Minimally invasive rhinoplasty technique using a hyaluronic acid filler and polydioxanone threads: an effective combination. Facial Plast Surg 2019;35:109-10.
- Jin HR, Kim SJ. Presentation patterns and surgical management of the complications of thread rhinoplasty. Clin Exp Otorhinolaryngol 2022;15:247-53.
- Lee HY, Yang HJ. Rhinoplasty with barbed threads. Plast Reconstr Surg Glob Open 2018;6:e1967.
- Kang SH, Moon SH, Kim HS. Nonsurgical rhinoplasty with polydioxanone threads and fillers. Dermatol Surg 2020;46:664-70.
- Helmy Y. Non-surgical rhinoplasty using filler, botox, and thread remodeling: retro analysis of 332 cases. J Cosmet Laser Ther 2018;20:293-300.
- Chen Y, Hu J, Xing J, Li Y, Xu Y, Li N, et al. Complications following thread rhinoplasty. J Cosmet Dermatol 2022;21:4722-6.
- Kang K, Kim MH, Byeon HS. A case of temporary correction of drooping nose due to postoperative descent of silicone implant using a filler injection. J Cosmet Med 2020;4:41-5.
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