Does nose filler spread? Do nose threads poke through?

When people come in to ask about nose filler or nose threads, two worries come up first: filler spreads, and threads poke through. Both are true, but only under certain conditions.

Filler spreads when more is used than needed. Filler is a fluid that can flow, and it can only withstand so much pressure. If the shape of the nose is built with filler alone, the filler has to withstand more pressure, and beyond a certain point it spreads. That’s why, back when filler was used on its own, the nasal bridge often grew wider over time.

So these days, the basic framework is set with threads, and filler is kept to the minimum needed. When the filler has to withstand less pressure, it spreads less.

Nose threads can push through the skin. In the past, straight (I-shaped) threads were widely used in both the nasal bridge and the columella (the column of skin between the nostrils). Because they’re straight, they slip up and down easily, and because their ends are sharp, a thread that shifted close to the skin could irritate it again and again until the end pushed through.

Seen from the side, the nose looks like the letter L: the bridge is longer than the columella, and the line bends at the tip. LSCO is an L-shaped thread that follows this shape. It is anchored at two points, the bridge and the columella, so it doesn’t shift easily, and I designed it so that a rounded surface, where the thread folds into an L, rests against the tip instead of a sharp end.

A straight thread only propped up the tip cartilage from below, so its effect on the tip often didn’t last long. LSCO does two things at once: it lifts and supports the cartilage, and its folded part fills the tip directly.

Nose threads are made of absorbable PDO (polydioxanone), a material also used for surgical sutures. It breaks down in the body over time by hydrolysis. Unlike filler, it’s a solid that doesn’t flow, so it doesn’t spread, and as the body responds, collagen fills the space where the thread was.

So Nose LINE ON, our non-surgical nose shaping treatment, starts with 4 LSCO threads and adds the minimum amount of filler needed. It combines the strengths of threads and filler.

Here is what the research shows. When nose filler migrates and the area between the eyes becomes wide and blunt, it’s known abroad as an “avatar nose.” A 2025 cadaver study found that the ligament between the eyes (the nasofrontal ligament) takes much more force to penetrate than the surrounding tissue, and used this to explain how the path migrating filler takes relates to this shape. Filler can also stay longer than you might think. In a 2024 study that looked at MRI scans of 33 people who had filler in the midface, no one’s filler had completely disappeared within 2 years. If you keep adding filler to the same spot because the effect seems to have faded, it can build up.

Threads pushing through the skin have also been reported. A 2022 study of 30 people who sought care for complications after thread rhinoplasty found infection in 46.7% and thread protrusion in 30%, and 70% had been treated somewhere other than a medical facility. A 2024 review listed thread protrusion, migration and infection as typical side effects and stressed the importance of noticing them early and treating them. No study has yet directly compared whether L-shaped threads push through less often than straight threads. The L-shaped design is a judgment based on the shape of the nose and the way threads work their way out, which is why I follow your progress with you after treatment.