Closed Rhinoplasty in Korea: Thread Removal, Dorsal Hump Correction & Tip Refinement

One of the most common concerns we see at Noselab Plastic Surgery is patients who have previously undergone thread rhinoplasty — a non-surgical procedure using dissolvable threads to temporarily lift or define the nose — and are now ready for a permanent, natural-looking result. This case illustrates exactly that journey: a patient presenting with residual thread material, a visible dorsal hump, and an undefined nasal tip who chose closed rhinoplasty with Dr. Chayoung Kang for a comprehensive correction.

Patient Background: Why Thread Rhinoplasty Often Leads to Surgical Revision

Thread rhinoplasty has grown popular as a “lunchtime” nose job across Asia, promising subtle augmentation or lifting without incisions. While threads can offer temporary improvement, they are not a substitute for structural surgery. Over time, patients frequently encounter one or more of the following issues:

• Thread migration or palpability: Threads can shift from their original placement, creating visible ridges or asymmetry under the skin.
• Fibrosis and scarring: The body’s healing response around the threads forms fibrous tissue that can distort nasal shape.
• Incomplete correction: Threads cannot address underlying structural concerns such as a bony or cartilaginous dorsal hump, a drooping tip, or a wide nasal base.
• Fading results: As threads dissolve, patients often find themselves back at — or in a worse position than — their starting point.

This patient’s experience reflects a familiar pattern. Thread rhinoplasty had provided only modest, short-lived improvement while leaving behind residual material and mild tissue irregularity. Her true goals — a smoother nasal profile, reduced dorsal hump, and a refined, elevated tip — required a permanent surgical solution.

Surgical Plan: What Was Addressed

After a detailed consultation and photographic analysis with Dr. Kang, the following surgical goals were established:

1. Thread Removal

The first priority was complete removal of the existing thread material. Residual threads — whether partially dissolved PDO (polydioxanone) or other types — must be extracted before any structural work can proceed. Leaving threads in place during rhinoplasty risks infection, uneven healing, and unpredictable long-term results. Dr. Kang carefully identified and removed all accessible thread remnants through the internal approach, minimizing disruption to surrounding tissue.

2. Dorsal Hump Correction

A dorsal hump refers to a convex prominence along the bridge of the nose, composed of bone in the upper portion and cartilage in the middle third. This patient presented with a mild-to-moderate hump that created a convex profile rather than the smooth, straight-to-slightly-concave dorsal line preferred in aesthetic rhinoplasty.

Correction involved precise rasping and cartilage reduction to create a harmonious profile line. In closed rhinoplasty, this is performed entirely through the nostrils — no external incision, no visible scar. After hump reduction, the nasal bones are assessed: if reduction creates an “open roof” deformity (a gap between the nasal bones), controlled osteotomies are performed to bring the bones together and restore a natural-looking bridge width. This step requires a high level of surgical precision, as over-reduction can create a saddle nose or pinched appearance.

3. Nasal Tip Refinement and Elevation

The nasal tip is often considered the most technically demanding area of rhinoplasty. This patient desired a more defined, slightly elevated tip — moving away from a boxy, drooping appearance toward a refined point with appropriate projection.

Dr. Kang addressed the lower lateral cartilages (the paired cartilages that form the framework of the tip) using suture techniques and cartilage grafting as indicated. A columellar strut graft — a small piece of cartilage placed between the medial crura — provides long-term support and helps maintain tip projection and rotation. These refinements create a tip that looks naturally sculpted rather than surgically altered.

Why Closed Rhinoplasty? Dr. Kang’s Approach

Dr. Chayoung Kang has built her practice around the closed rhinoplasty technique, and for good reason. In open rhinoplasty, a small external incision is made across the columella (the strip of skin between the nostrils), allowing the skin to be lifted entirely off the nasal framework. While this provides an unobstructed view, it also means a visible scar, greater tissue disruption, more swelling, and a longer recovery period.

Closed rhinoplasty, by contrast, uses incisions placed entirely inside the nostrils. The approach offers several significant advantages:

• No external scarring: With no incision on the columella, there is no visible scar — an important consideration for patients concerned about detection or for those who have already experienced scarring from prior procedures.
• Reduced swelling and faster recovery: Because the nasal skin envelope is not fully elevated, post-operative edema resolves more quickly. Most patients are socially presentable within 10–14 days.
• Preserved tissue integrity: Less disruption to the vascular supply and lymphatic drainage of nasal skin leads to healthier healing and a more natural final result.
• Natural-looking outcomes: The structural changes are made precisely and conservatively, respecting the natural anatomy rather than radically altering it.

Closed rhinoplasty is technically more demanding than the open approach because the surgeon must work through limited access. Dr. Kang’s extensive experience with this technique allows her to achieve complex structural corrections — including hump reduction, tip work, and thread removal — without resorting to external incisions.

Recovery Timeline: What to Expect

Understanding the recovery process helps patients set realistic expectations and plan their visit to Korea accordingly.

For international patients planning a trip to Korea specifically for rhinoplasty, Dr. Kang typically recommends a minimum stay of 10–14 days to accommodate surgery, the initial recovery period, and the splint removal appointment.

Results: A Natural Profile Transformation

As seen in the before-and-after images above, the outcome reflects the core philosophy at Noselab: subtle, harmonious, and natural. The dorsal hump has been smoothed into a clean profile line. The nasal tip is visibly more defined and slightly elevated, improving the overall balance between the nose and surrounding facial features. Crucially, the result does not appear “operated” — a benchmark that Dr. Kang applies to every case.

The removal of thread material also allowed for more predictable healing, with no residual irregularity or asymmetry that threads can sometimes cause. Starting with a clean structural foundation enabled the surgical corrections to settle evenly and naturally.

Is This Procedure Right for You?

You may be a good candidate for this type of combined procedure if:

• You have previously had thread rhinoplasty and are unsatisfied with the longevity or extent of results
• You have a dorsal hump you would like reduced
• Your nasal tip lacks definition, appears drooping, or is disproportionately wide
• You prefer a scarless approach with a shorter recovery
• You are in good general health with realistic expectations about surgical outcomes

Patients with very complex revision cases, severe septal deviation, or significant skin thickness may be better served by an open approach — this is assessed individually during consultation.

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