Thread Rhinoplasty: An Update and Literature Review

Background: Thread rhinoplasty has emerged as a minimally invasive alternative to surgical rhinoplasty for nasal aesthetic enhancement. This technique utilizes absorbable or non-absorbable threads to achieve nasal tip elevation, dorsal augmentation, and structural support without surgical incision. This comprehensive review examines the current state of thread rhinoplasty techniques, clinical outcomes, and safety profiles reported between 2018 and 2023. Methods: A systematic literature search was conducted in MEDLINE, PubMed, and Ovid databases for studies published between January 2018 and December 2023. Keywords included “thread rhinoplasty,” “PDO threads,” “non-surgical rhinoplasty,” “nasal thread lift,” and “absorbable suture nose.” Studies were classified according to the Oxford Centre for Evidence-Based Medicine levels of evidence hierarchy. Approximately 60 studies were analyzed, including prospective cohorts, case series, systematic reviews, and technique descriptions. Results: Thread rhinoplasty primarily employs polydioxanone (PDO), poly-L-lactic acid with polycaprolactone (PLLA-PCA), and pure polycaprolactone (PCL) threads. Patient satisfaction rates ranged from 62–95% at follow-up intervals of 6–24 months, with higher satisfaction at shorter intervals. PDO threads demonstrated effect duration of 8–12 months, while PLLA-PCA threads showed longer-lasting results of 18–30 months. Objective measurements revealed nasal tip elevation of 2–3 mm and nasolabial angle increases of 6–8 degrees. Common applications included nasal tip elevation, dorsal augmentation, columellar support, and nasolabial angle modification. Complications were generally minor including transient swelling (15–85%), bruising (20–45%), thread visibility (5–15%), skin dimpling (3–12%), infection (2–8%), and thread extrusion (1–5%). Combination approaches with hyaluronic acid fillers demonstrated superior outcomes compared to thread-only techniques. Asian populations constituted the predominant study demographic, reflecting cultural preferences for nasal augmentation procedures. Conclusions: Thread rhinoplasty represents a viable minimally invasive option for patients seeking temporary nasal aesthetic enhancement with mild to moderate concerns. Absorbable materials provide predictable safety profiles with reversibility advantages. Patient selection remains critical, with optimal candidates presenting thin skin, realistic expectations, and understanding of temporary effect duration. Continued research with standardized outcome measures and long-term follow-up studies would strengthen the evidence base for this evolving procedure.