Nasal Reshaping Using Barbed Threads Combined With Hyaluronic Acid Filler and Botulinum Toxin A

Rhinoplasty is a prominent procedure in facial aesthetics, but extended surgical downtime remains its significant limitation. Nonsurgical rhinoplasty has gained popularity as an alternative, offering significant aesthetic improvements with minimal downtime. This study evaluates the clinical efficacy and safety of three nonsurgical rhinoplasty techniques combined, including hyaluronic acid (HA) filler, botulinum toxin type A (BTX), and barbed lifting threads.

A total of 85 patients were included into three groups: 63 subjects received HA filler and BTX injections, 9 subjects received barbed threads followed by BTX injections, and 13 received threads followed by HA filler and BTX injections. Patients assessed their satisfaction 1 month and a year posttreatment as well as adverse effects 48 h and 1 week after treatment using FACE-Q questionnaire for nose.

Both 1 month and a year after treatment, the triple combination of barbed threads with HA filler and BTX demonstrated superior nose FACE-Q scores compared to the two other groups, showing highest patient satisfaction and minimal efficacy decay over time. No significant difference in FACE-Q scores was observed between the two groups receiving HA filler + BTX and barbed threads + BTX at either 1 month or a year posttreatment. Adverse effects were reported by subjects in all three groups 48 h posttreatment and completely resolved by 1 week after treatment.

Combining nonsurgical rhinoplasty techniques-such as lifting threads, HA fillers, and botulinum toxin-can deliver effective aesthetic improvements with minimal downtime. Among these, the triple combination of HA filler, BTX, and lifting threads results in the highest and most sustained patient satisfaction, lasting no less than 1 year.