Clinical Features of Skin Infection After Rhinoplasty with Only Absorbable Thread (Polydioxanone) in Oriental Traditional Medicine: A Case Series Study

Overview

Polydioxanone thread is an absorbable suture material used increasingly in traditional medicine clinics for cosmetic purposes including nose reshaping. As its use grows, so do complications. This case series describes what the authors saw in patients referred after such procedures.

Sections of note

• Seven patients, 3 male and 4 female, presented between August 2018 and July 2019 with complications after rhinoplasty with polydioxanone thread.
• Ultrasonography and laboratory findings including wound cultures were obtained.
• Conservative treatment with antibiotics was used, and three patients underwent surgery.
• Three patients had severe complications: open wounds, abscesses, and skin necrosis.
• Four had mild complications: redness and thread exposure without open wounds.
• Infection sites were the nasal tip and the inner lining; six of the seven had a history of previous rhinoplasty.
• Ultrasound showed abscess formation around the previously inserted implant; during surgery the thread could not be seen except in one patient. Level of evidence IV.

What it means for a patient

• The thread is invisible on imaging and usually cannot be found at surgery, so the infection is treated by removing the underlying implant instead.
• Six of the seven already had a nasal implant, and the authors advise against thread procedures in anyone who does.
• Milder cases settled with antibiotics; the thread absorbs after about six months.
• Limits: seven patients at one clinic, so this describes the pattern of complications without indicating how often they occur.

Why this paper matters

Thread-based nasal procedures are performed outside conventional surgical settings and their complications reach plastic surgeons later. Documenting that the thread is undetectable and that prior implants are the risk factor is practical guidance. The series cannot establish a complication rate.

Terms

• Polydioxanone: An absorbable suture material that dissolves over months.
• Absorbable thread: A suture the body breaks down rather than one that stays permanently.
• Abscess: A collection of pus walled off within tissue.
• Skin necrosis: Death of skin tissue from loss of blood supply.
• Debridement: Surgical removal of infected or dead tissue.