Complications following thread rhinoplasty

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.

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

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.

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 nonmedical places (70%). Ultrasonography of infection showed multiple dotted heterogeneous hyperecho signals surrounded by a hypoecho area. Twenty 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.

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.