Rhinoplasty Case: Resolving a Bulbous Nose After Filler and Hiko Thread Lift (by Dr. Young-moon Yoo, VIBE Plastic Surgery)

Hello.

I am Dr. Young-moon Yoo, Director of VIBE Plastic Surgery.

Today, I would like to introduce a case of rhinoplasty using costal cartilage for a patient who visited us after being dissatisfied with the results of previous nose fillers and Hiko (thread lift) procedures.

✔ Pre-operative Concerns: Why was the patient dissatisfied?

The patient had already undergone bridge filler and Hiko (thread lifting) procedures, but remained highly dissatisfied because:

✔ The nose still appeared bulbous

✔ The nasal tip looked droopy

✔ The overall impression was that the nose looked too large

👉 While fillers and Hiko can help temporarily supplement height and support, they often have limitations in resolving issues like a bulbous tip, drooping tip, or the nasolabial angle.

✔ The Solution: Foreign Body Removal + Costal Cartilage Rhinoplasty

In this case, I determined that a structural redesign was necessary rather than simple additional procedures.

🔹 1. Dissolving Bridge Filler

Existing filler can make the nose line look dull and heavy, so it was safely removed using filler-dissolving injections.

🔹 2. Hiko Thread (Foreign Body) Removal

Remaining threads can cause inflammation, adhesions, and asymmetry, so they were cleanly removed during surgery.

👉 Accurate and stable rhinoplasty is only possible after clearing out these foreign substances.

✔ Why Costal Cartilage Was Chosen

The core of this surgery was improving the nasal tip structure using donated costal cartilage.

Costal cartilage offers:

Availability of sufficient quantity

Strong structural support

Great advantages for correcting bulbous tips, drooping tips, and the nasolabial angle

👉 It helps to firmly elevate a drooping tip and ensures it does not sag again over time.

✔ Surgery Summary

The following corrections were performed in this case:

✔ Bulbous tip correction using costal cartilage / Drooping tip correction (strengthening the tip support structure) / Nasolabial angle correction for a sophisticated profile

✔ Use of a natural silicone implant for the bridge

👉 Moderate height for the bridge & firm support for the tip

👉 The goal was an overall natural and refined nose line.

✔ Why Silicone Implants Were Used Together

Once the filler is dissolved and threads are removed, the bridge of the nose often becomes lower and more uneven than expected.

In such cases, using a natural, thin silicone implant can actually result in a cleaner and more stable line.

👉 The important thing is not a blind preference for ‘no-implant’ vs. ‘implant,’ but rather where and what materials are used.

✔ Post-operative Changes

After the surgery:

The bulbous impression was improved

The drooping tip became sharp and defined

The nasolabial angle was refined, completing a sophisticated side profile

The ‘stuffy and heavy’ feeling experienced with fillers and Hiko disappeared, replaced by a much lighter and more natural nose.

✔ Recommended For:

Those who have had fillers or Hiko but are still unhappy with their nose

Those concerned about a bulbous tip + drooping tip

Those who want fundamental nose improvement along with foreign body removal

Those who want long-lasting results from a single surgery

Closing Thoughts

While nose fillers and Hiko are convenient procedures, they do not solve all nasal issues. Having already had these procedures does not necessarily put you at a disadvantage.

👉 With accurate removal and a proper revision surgery plan, you can achieve highly satisfactory results.

At VIBE Plastic Surgery, we perform customized rhinoplasty that takes your entire procedure history into account.

Consultations and surgeries should be performed by a board-certified plastic surgeon!

The VIBE that comes from rich experience

Dr. Young-moon Yoo, Representative Director of VIBE Plastic Surgery

VIBE Plastic Surgery complies with all medical laws. These before-and-after photos were taken under the same conditions with the patient’s consent. Complications and side effects such as bleeding, inflammation, infection, and asymmetry may occur after surgery and vary by individual; caution is required.