Thread Lifting of the Nose: Fully Comprehensive Approach to the Technique.

Nose thread lifting is a relatively recent technique. It offers a chance to approach nose morphology defects without turning to surgery to obtain a temporary improvement. Nevertheless, it lacks standardization and it can therefore offer quite variable results and short durability. The authors' experience is presented here along with a recommended methodological approach to deliver reliable techniques for predictable results. Thread lifting techniques for nose reshaping by means of insertion of poly-L-lactic/poly-caprolactone threads are presented, based on principles of graft-based techniques, to obtain temporary morphological correction of selected nose deformities. Methods: A total of 553 patients underwent nose reshaping using poly-L-lactic/poly-caprolactone threads. Of the procedures, 471 were primary treatment, and 82 were secondary treatment after a previous rhinoplasty. The mean follow-up period was carried out through patient photographs and lasted 33.4 months (range 2-60 months). Clinical examinations and patient satisfaction surveys were done at 6 months and 1 year from thread lifting. Results: The Freiburg questionnaire survey (subjective Global Aesthetic Improvement Scale) allowed the authors to confirm a 95% satisfaction rate after 6 months, and 62% at 1 year after treatment. A flow chart based on the recorded results is presented to support operators in selecting the proper correction method to adopt, based on the different listed indications. Conclusions: Nose reshaping techniques with poly-L-lactic/poly-caprolactone threads are presented together with patients' treatment satisfaction. Standardization is based upon the authors' experience. Contraindications and encountered complications are discussed, so as to provide the readers with a complete "state-of-the art" presentation of these techniques. In the authors' experience, this is a reliable and safe approach to obtain temporary amelioration of selected nose defects via a nonsurgical and minimally invasive method.