Hiko Nose Thread FAQ

What are HIKO nose threads?

Hiko nose threads were developed 15 years ago in Seoul.  “Ko” means nose in Korean so HIKO is an acronym meaning ‘high nose’. The threads are made from Polydioxanone or PDO in short. PDO is a biocompatible, as well as, biodegradable material that is degraded over 6-12 months. PDO is traditionally used as  surgical suturing material. 

How can HIKO nose threads improve the aesthetic of my nose?

Hiko nose threads are ideal for people who would like more height to the bridge of their nose, it provides a subtle lift that mimics bone. The threads can also raise the glabella (area between the eyes) and provide structural support to the columella, which in turn supports and lifts the tip. If someone has a bump, dermal filler might be necessary in addition to HIKO threads.

What are the benefits of threads vs dermal filler in the nose?

The glabella and nose are some of the high risk areas to inject dermal filler. The reason for this is that the arteries of the nose are connected to the arteries of the eyes. Filler can be inadvertently injected into one of these arteries which could in turn lead to irreversible blindness. Fortunately to date, not a single case of blindness following threads, have been reported in the scientific community.  

Other benefits include a negligible risk of skin necrosis and no lateral migration. Lateral migration of dermal filler in the nose can lead to the appearance of an “Avatar” nose which we would recommend a patient dissolve. This often happens if a hydrophilic dermal filler was used in the nose, the correct choice of filler in the nose is essential.

Hiko nose threads also have incredible longevity and even though the threads start degrading after 6 months the benefits are seen for 12- 24 months. A patient can repeat the treatment if and when they choose to do so.

The quick recovery time is also a bonus. The procedure is performed in the office and takes about 20 minutes. We do recommend you take things easy on the day but there are no major restrictions after the procedure.

What are the downsides or risks of threads?

Threads can’t be readily removed and if necessary might require surgical removal, alternatively you have to wait for them to be biodegraded.

Infection is a risk and therefore strict sterile technique and procedures need to be followed. We routinely prescribe a week of antibiotic prophylaxis with every HIKO nose treatment, as the threads are technically a biological implant.

Thread protrusion is rare, but may occur. The protruding thread will be removed by your doctor without any untoward issues. Prophylactic antibiotics will be prescribed in these rare instances.

Another downside is that not everybody is a good candidate for threads and this is where consultation with your doctor is very important. Each individual patient needs to be assessed and then we would recommend either a surgical or a non-surgical approach. If a patient needs surgery or a revision rhinoplasty we would refer them. Non- surgical options available at our clinic include dermal filler, HIKO nose threads or a hybrid treatment where we will combine threads and dermal filler. This may or may not be done on the same day depending on the specific case.

In some instances the needle entry point can leave a small 1-2mm depression which usually resolves itself.

Allergy to the PDO material is very rare but has been reported.

What does the procedure involve?

The face is cleaned and all make-up removed. We then sterilise the entire face with chlorhexidine and surgical alcohol. Local anaesthetic is injected along the bridge, the tip and the base of the nose. The anaesthetic may or may not include a small amount of Adrenaline. The benefit of adding Adrenaline is that it can minimise bruising, it does however, cause some temporary blanching of the skin.

Once the nose is anaesthetised the doctor using sterile technique will make one or 2 entry points with a needle on the nose. The position of the entry points may vary according to the desired outcome. The threads are then placed horizontally on the bridge and vertically into the tip.

The amount of threads used will vary depending on the desired effect. We then place a small amount of antibiotic ointment on the entry point and place a very small steri-strip over the entry point. The steri-strip may fall off within an hour or so which is fine as the entry point seals rapidly.

How can I prepare for my procedure?

Planning for any procedure is always a great idea. Having the following day off from work or any important meetings is always ideal, although not always possible!

Avoid alcohol and elective blood thinners like Aspirin, Nurofen and fish-oil for a week prior to your appointment. Alternatively, inform your doctor if you are on prescription blood thinners.

What is the aftercare?

Bruising and swelling are common,but fortunately, in the case of nose threads, tend to be minimal.

Patients often report some discomfort especially at the tip and base of the nose. Simple analgesics including Panadol and Nurofen are effective in managing the discomfort which can last up to 2 weeks.

We recommend avoiding heavy exercise on the day.  Ice packs can be applied to help reduce any swelling. Arnica and Bromelain are also recommended for a speedy recovery. Make up can be worn on the same day as long as it’s not near the entry points, however, we would recommend no make up for 48 hours if possible.

Before and after Hiko nose threads
Before and after Hiko nose threads at The Manse Clinic, Sydney