Non-Surgical Nose Augmentation Combination Therapy

According to Nonsurgical Rhinoplasty With Polydioxanone Threads and Fillers (2020) For decades, surgical rhinoplasty has been the treatment of choice. However, with the advent of various synthetic fillers, nonsurgical rhinoplasty with injectable fillers & threads has gained popularity over the years.

The major strength of filler & thread rhinoplasty is that it provides immediate, visible result in the convenience of an office setting. Despite it’s temporary longevity, it is popular because it is simple, effective & economical.

What is Non-Surgical Nose Augmentation?

The nose is at center of the face. So it takes important role to determine your overall facial balance. When doing rhinoplasty, rather than considering about height of nose, from an aesthetic viewpoint it would be better to prioritise overall harmony of the face.

Non-surgical rhinoplasty involves the use of injectable fillers that focus on the small changes in one’s nose. Not only do these small adjustments translate to big improvements in appearance, the fillers themselves are also dissolvable and easily reversible should one decide against it.

Plastic surgery has evolved in a less invasive direction. Many procedures and techniques for nose augmentation have been investigated to avoid invasive surgery while retaining improved results.

In the Asian population, the nasal tip is often underprojected, and for non surgical rhinoplasty to produce a more pleasing appearance, it needs to reliably raise the tip and modify the nasolabial angle which a thread lifting is able to achieve when inserted to the nasal dorsum and columella.

It is also important to note non-surgical rhinoplasty is performed purely for cosmetic reasons. Physical restructuring of the nose to alleviate certain deformities still requires an individual to perform surgical rhinoplasty instead.

Nose Fillers

Dermal fillers injected into dermal layers of the skin are typically used to promote and boost moisture retention with their hyaluronic acid or collagen-stimulating compound. However, in cases like these, they add extra volume into the target area to define facial features.

As volume is added to these target sites, they provide the desired shape and a more distinct nasal contour. For example, an uneven nose bridge can be smooth out by filling out other areas of the bridge and turning the uneven surface straight.

The result of nose fillers usually lasts for nine to 12 months depending on the brand and type. Also, if you find that you do not like how it looks, you can reverse the procedure by injecting a filler dissolvent.

Injection Technique

The subdermal / subcutaneous plane can be manipulated quite freely and painlessly. Dermal fillers should be injected using a retrograde linear threading technique involving fanning. The cannula or needle tip should remain in the skin whilst fanning. (Although the recognised layer to inject fillers in nose modulation is the supraperiosteal layer, this is present in the upper third of the nose only, while the lower part has just smooth cartilage and heavy skin.)

Each thread injected should consist of 0.05-0.1ml and the total volume on each side will usually be between 0.5-1ml. Following treatment, the skin is gently cleaned and gently massaged. Appropriate aftercare instructions must be provided, together with arrangements for a follow-up appointment.

Nose Thread Lift

The basic mechanism behind the Korean thread lift technique is due to the properties of threads used in this treatment. The threads act as a mechanical scaffold as they provide support and lift the bridge and tip of the nose. They are inserted in the midline along the nasal septum and bridge, and into the tip of the nose. This provides height and projection as a result of which your nose appears taller, slimmer, and sharper.

Moreover, the threads induce triggers in the skin to produce collagen. Collagen provides additional support to the nose. Therefore, a continuous improvement is observed after the treatment.

Thread lift is the process of inserting surgical threads made of Polycaprolactone (PCL) or Polydioxanone (PDO) material into the target area of the skin to lift or elevate features.

Thread lifts can be used for a variety of areas including the nose for enhancements such as redefining and straighten the nose contour, lift the nose tip, and increase the height of your nose by lifting the nose bridge. Nose thread lift can also be used to reshape the base of the nose as well, lifting it up and allowing the nose to look sharper and more defined. Such procedures have been widely favoured as an alternative to rhinoplasty as nose thread lift is seen as an option with less downtime and more affordable than surgical methods.

When these dissolvable threads are inserted into the middle of the nose bridge through the tip, they straighten the bridge of the nose and create a higher-looking silhouette. The added volume of the threads then helps to increase the height and straightness of the nose.

Once inserted, these threads act as a scaffolding structure that immediately helps to contour, define, sharpen, lift and/or shape the nose as desired without surgery.

The result of this procedure typically lasts for about one to two years depending on the material used, individual lifestyle and bodily reactions. There is minimal downtime for this – about one to two days of discomfort around the area and it may also take about three to five days for the thread insertion point to heal. Possible side effects include mild swelling at the insertion site for about one to two hours.

Polycaprolactone (PCL) Thread Lift

Polycaprolactone (PCL) threads are the latest monofilament suspension threads of synthetic origin (caprolactone). They regenerate collagen for a longer period than PDO threads.

PCL is very flexible and highly elastic substance it is also biodegradable and decomposed into CO2 and H2O. Its safety is proven from various biodegradable medical devices approved by the US Food and Drug Administration (FDA).

Threads made from PCL are slowly absorbed into the body within 1 ~ 1.5 years compared to PDO (6 ~ 8 months). For functional improvement of the collagen synthesis and wrinkle improvement, the new PCL thread with less residual monomers and a higher molecular weight has been developed expecting prolonged durability and enhanced efficacy.

Polydioxanone (PDO) Thread Lift

PDO is a synthetic polymer which hydrolyzes over a period of 6 months.

Its absorbable nature prevents long term complications associated with alloplastic implants such as infection or extrusions. In addition, it has been reported that the breakdown products of PDO have bacteriostatic properties.

PDO threads and fillers act synergistically in the nasal dorsum. Here, they act as reinforced concrete, a composite material where the concrete (filler)’s relatively low tensile strength and ductility are counteracted by the inclusion of reinforcement (PDO) having a higher tensile strength or ducility.

Threads lengthen, strengthen and raise the columella, enbaling the tip to project in the anterior direction which makes the tip pointier.

Also, by lengthening the columella, threads improve nostril inclination and stretch the ala in the anterior direction. With the changes the nose becomes long and narrow when seen from the basal angle.

Conclusion

Nose thread lift is a minimally invasive aesthetic treatment available to improve the appearance of the nose. People who have a big and wide nose, depressed nose bridges, or bulbous nasal tips should get this treatment. There are numerous benefits to doing non-surgical rhinoplasty.

The whole procedure requires less than an hour for completion and has a very short downtime. If you are not satisfied, the results can be reversed. Results are not permanent but are persistent for several months or even up to a year. If proper aftercare is done, the risks of side effects are minimal.

Reference

Nonsurgical Rhinoplasty With Polydioxanone Threads and Fillers (2020)

Surgical anatomy for Asian rhinoplasty by Taek Kyun Kim, Jae Yong Jeong (2019)

The Ultimate Guide to Non-Surgical Nose Job! by Zoe Medical (2021)

Efficacy study of the new polycaprolactone thread compared with other commercialized threads in a murine model by Seung Woo Cho MD, Byung Ho Shin PhD, Chan Yeong Heo MD, PhD, Jung Hee Shim PhD (2021)

Hiko nose Threadlift: New Updates and Commonly Asked Questions by Dr Rachel Ho (2022)

Hyaluronic Acid Filler Injection by Entokey (2019)

What You Need To Know About Nose Thread Lifts by Dream Plastic Surgery (2021)

23 Injectable Fillers of the face by Myriam Loyo, Linda N. Lee, and Theda C. Kontis (2020)

Uncovering the benefits, indications & limitations of the thread lifting in our upcoming

Korean Advanced Non-Surgical Face Lifting Hand-On Master Classes/Mini Fellowship happening globally: