22 June 2022
Song Hye Ko’s nose is often used as a reference by many patients coming for a nose job. This includes my patients requesting for the Hiko nose threadlift!
A defined and sharp nose is almost universally regarded as the ideal nose across different cultures and ethnic groups. Unfortunately for Asians, a flat or low nose bridge and upturned nose tip are the common features in the Asian nose. The nose is the most defining feature of the face and the nasal profile has an impact on all the other features of the face. For example, a flat nose bridge makes the eyes look wide apart and the face broad looking. It is no surprise that nose enhancement or nose augmentation is widely popular in Asia, especially in Singapore, Korea, Malaysia and the Philippines. I’m also seeing patients coming in from non-Asian countries like Australia, UK, US and Canada and this is probably because the Hiko nose thread lift is now becoming globally recognised as a safer and better alternative to nose fillers for non-surgical nose rhinoplasty.
While rhinoplasty has traditionally been the only modality to augment the nose, many patients are hesitant about nose surgery. This is understandable. The need for general anaesthesia, incisions, risk of scarring and harvesting cartilage from the ribs or ear- make one wonder whether the price of beauty is worth the cost.
In the last decade, two newer treatments have emerged to change the game for nose augmentation without surgical rhinoplasty. Nose fillers and Hiko nose threadlifts are the two types of non-surgical nose job. Nose fillers and Hiko nose threadlifts have seen a rise in their popularity since their advent, especially in Asia. No surprises there- the Asian nose typically has is short, has a low nose bridge, upturned nose tip (over-rotated), inadequate columella and bulbous tips. In these instances, nose fillers and Hiko nose threadlifts are non-surgical options to correct the nose.
An emerging trend in non-surgical nose augmentation is the use of fine, absorbable threads to mechanically “lift” up the nose. Better known as the Hiko nose thread lift, this procedure originated in Korea and can address some of the problems of nose fillers.
Hiko comes from the words “high” and “ko” (for nose in Korean) and its name is self-explanatory. Compared to nose fillers, Hiko nose threadlift can lift up the nose bridge better than nose fillers and improve tip projection and rotation. The results arevery natural and the risk of vessel occlusion is almost negligible. The effectiveness and safety of the Hiko nose thread lift make it a preferred choice of nose augmentation in Asia.
The threads used in a Hiko nose threadlift are made up of polydioxanone (PDO). PDO is a material that has been used in surgical sutures for many years. These threads are fully dissolvable in the body within 6-9 months. Hiko nose threadlift works by a two-pronged mechanism. Firstly, the threads mechanically prop up the nose tissues wherever they are placed. Secondly, the threads contain little barbs along their length. As the nose threads dissolve, the threads will stimulate natural collagen production by your own tissues. What this means is that the results of this nose job will continue to improve and be sustained, making it a more desirable option than nose fillers.
This is what a thread used for the Hiko nose threadlift looks like. A fine, soft thread with a sturdy blunt cannula to guide the placement of the thread.
PCL Cog nose threads.
Yko (N-cog) PDO cog threads.
I use both PDO and PCL threads and also both mono and cog threads for the Hiko nose threadlift. Each type of thread has its advantages and disadvantages. The choice of threads for the Hiko nose threadlift should be tailored for every single patient.
The Hiko nose threadlift lifts and enhances both the nose bridge and nose tip by 2 mechanisms.
1) Mechanical lift- the fine threads mechanically prop up the nose bridge and tip. This increases the nose bridge height and projection for a taller, more defined and slimmer nose bridge. When the nose threads are placed in the nose tip, the nose tip rotation is improved for a slimmer nose tip.
2) Biochemical- the advantage of the Hiko nose threadlift over nose fillers is that the nose threads stimulate the tissues of the nose to produce its own collagen so that the results of the nose job will continue to improve and be sustained.
1) Higher nose bridge
2) Longer nose bridge
3) Sharper and slimmer nose bridge
4) Straighter nose bridge for deviated noses
5) Sharper and slimmer nose tip
6) Improved tip rotation
First, I make measurements and draw markings on the nose
The nose is numbed with numbing cream for 15 minutes. Next, I inject local anaesthesia along the nose bridge and nose tip.
I use a small needle to create an entry point for the threads after the nose is numbed.
Lastly, I insert the nose threads into the bridge of the nose and/or nose tip via blunt cannula. The cannula is removed after the threads are inserted
The entire Hiko nose thread lift takes approximately 20 minutes
There is negligible downtime for the nose threadlift and you can return to your daily activities and work immediately after the Hiko nose thread lift. I prefer the nose thread lift to nose fillers because Hiko nose threadlift is very stable and secure. The nose threads will not be displaced or migrate even with pressure to the nose. You can also apply makeup to the nose after the nose thread lift. There is very little bruising and swelling. The swelling is usually due to the injection of local anaesthesia.
The Hiko nose threadlift is much safer than nose fillers mainly because there is no risk of vessel occlusion and the attendant complications like skin necrosis and blindness
· Immediate results
· Longer lasting than nose fillers
· Good for lifting up flat nose bridge
· Cannot be dissolved
· Cannot correct nasal dorsal humps or bumps.
Complete your medications as prescribed by your doctor for your Hiko nose thread lift. In my clinic, this usually includes antibiotics to prevent infections and anti-bruising and swelling medication. Avoid alcohol and health supplements like fish oil as these can worsen any bruising. You can wear make up after your Hiko nose thread lift, except over the entry point.
The threads for the Hiko nose threadlift come sealed in packs for sterility. I have been using a brand called Ultra V Hiko for years because it has proven to be safe and achieve good results in my patients.
Both nose fillers and the Hiko nose threadlift are excellent ways to improve the appearance of the nose without having to go under the knife and general anaesthesia. Both procedures are not without their limitations and one way to overcome these limitations is to combine both the Hiko nose threadlift and nose fillers.
A good example is a patient with a very flat nose bridge with a hump. The Hiko nose threadlift can lift the nose bridge and a little filler can then be introduced to smoothen out the dorsal hump. The results of combing both treatments are also very natural as now, less filler and threads have to be used together with the combined technique.
As nose augmentation is a medical procedure, it is best to discuss the options with your doctor before proceeding.
Update: New Post Hiko Nose Threadlift: New Updates and Commonly Asked Questions
I prefer to use Restylane Lyft (formerly known as Restylane Perlane) or Juvederm Volux for nose fillers because of its high G’. What this means is that this particular nose filler is ‘harder’ and ‘firmer’ to retain the shape of the nose.
Nose fillers are an excellent way to correct and improve the appearance of the nose, especially for patients with humps on their nose in 15 to 20 minutes. The most commonly used filler material is hyaluronic acid, which is a naturally occurring substance in our bodies. Hyaluronic acid fillers typically last for 6-9 months. Other types of filler materials that can be used include calcium hydroxylapatite (Radiesse). Nose fillers, when done by experienced doctors, are very natural looking and will not give a fake or “overfilled” appearance.
Related blogpost: 5 Things You Need to Know About Nose Fillers.
Fillers can be placed anywhere on the nose to correct the specific problem- nose bridge, tip, columella etc. I choose the exact placement after an assessment a detailed discussion on an ideal nose that would suit the features of my patients.The key is to have a nose that is in harmony with the rest of your face. A nose job that is unnatural looking would be an unwanted source of attention.
In my practice, I first numb the nose with numbing cream. I then inject the dermal filler into the nose bridge or tip. There are 2 ways that the filler that I inject the nose filler- with a needle or a cannula. I also use fillers that contain lignocaine, a local anaesthetic which numbs the injection so there is very little discomfort if at all.
· Immediate results
· Fast (15-20 minutes)
· Best for correcting and smoothening out dorsal humps or bumps
· Minimal downtime
· Risk of filler migration, creating a broad nose or ‘Avatar’ look
· Lifting of nose bridge is not as obvious as compared to a nose thread lift
· Relatively short life span
· Mild swelling and bruising
· Vessel occlusion when the filler material blocks up blood vessels in the nose. This can lead to complications such as skin necrosis and blindness
The Hiko nose thread lift is very different from nose fillers. Some of the major differences are below:
Two of the biggest challenges of nose fillers that the Hiko nose thread lift has overcome are:
1. Safety- the risk of blindness and skin necrosis due to inadvertent entry of blood vessels by nose fillers is almost negligible with the Hiko nose thread lift. The threads are soft and fine do no penetrate blood vessels
2. Nose broadening or ‘Avatar nose’- Nose fillers have a tendency to spread sideways and widen the nose bridge towards the end of the lifespan of the fillers. This creates the appearance of an ‘Avatar nose’ that can be obvious. In the picture below is a patient who came to see me for a Hiko nose thread lift after she developed widening of her nose bridge after she had nose fillers done by another doctor.
And there you have it! A comprehensive review of the Hiko nose threadlift and nose fillers. To find out whether the Hiko nose thread lift or nose fillers work better for you, seek a doctor’s advise before making a decision!