Clinical features and literature review related to the material differences in thread rhinoplasty: Two case reports

Complications Following Thread Rhinoplasty

BACKGROUND

The debate on thread rhinoplasty (TR) has never stopped owing to its complications. However, few studies have reported the clinical characteristics of TR complications, as well as their treatment.

AIMS

We aim to summarize the clinical, ultrasonographic, and histopathologic characteristics of TR complications.

PATIENTS/METHODS

This retrospective case series study included consecutive patients presenting with TR complications. Patients demographics, medical history, complications, ultrasonography, treatment, histopathology, and follow-up outcome were collected through the electronic medical record.

RESULTS

A total of 30 patients (28 females) with an average age of 28.7±6.8 years were included. The most common complication leading to consultation was infection (46.7%), followed by thread extrusion (30%), chronic inflammation (16.7%), and dimpling (6.7%). Most patients who developed complications received TRs at illegal non-medical places (70%). Ultrasonography of infection showed multiple dotted heterogeneous hyperecho signals surrounded by a hypoecho area. 20 patients (66.7%) received debridement, thread removal, or release of dimpling. Threads could be completely removed within one month of TR. Histopathological examination showed multifocal crystal-like material surrounded by excessive inflammatory cells in hyperplastic granulation tissues. All patients were satisfied with the clinical outcomes over a follow-up of 25.6±14 months.

CONCLUSIONS

Infection is the most common complication that always warrants thread removal. Ultrasonography is helpful in detecting the remaining threads and delineating the infection area. We do not recommend threading as a regular method for rhinoplasty owing to its complications for an expedience with short-lasting effect.

Presentation Patterns and Surgical Management of the Complications of Thread Rhinoplasty

Objectives

Nonsurgical rhinoplasty using threads has gained popularity in recent years. While the benefits of this procedure have been emphasized, possible complications and their management are not well-known. This study aimed to present the surgical management and results of the complications of thread rhinoplasty.

Methods

We retrospectively reviewed the medical records of seven patients who underwent revision rhinoplasty due to the complications of thread rhinoplasty from January 2018 to May 2021. The presentation of complications, detailed surgical procedures, and outcomes of revision rhinoplasty were reviewed.

Results

Visible or extruded threads at the tip were the most common complication, followed by dorsum irregularity. All the threads were unabsorbed and intact in shape, even several years after insertion. Thread removal necessitated careful tissue dissection, resulting in the loss of tip support and dorsal irregularity. To restore the tip support and camouflage the dorsum shape, an autologous tissue graft was needed.

Conclusion

Removal of threads at the tip and dorsum was accompanied by structural weakening and partial tissue loss, which required tip support restoration and dorsum camouflage.