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Thrilled to share before and after results of my patient after a revision rhinoplasty. The patient is a very pleasant 39 year old woman that came to me complaining of a long standing infection for a year. She had a rhinoplasty 17 years ago, in which the original surgeon placed a synthetic implant. This became infected about 1 year ago!
In her preoperative photos, you can see that she has swelling, redness, and drainage from her nasal bridge. She also has what we call “saddling” of her nose. This refers to collapse of the nasal bridge. The goals of treatment were to eliminate the infection, correct the nasal deformity, and maintain the integrity of her breathing. She underwent a rhinoplasty with me with rib reconstruction through a minimally invasive 1.2 cm incision.
It is important for patients to recognize that placing foreign and synthetic implants in the nose carries a serious risk of infection, not only at the time of surgery, but many years later. This patient developed an infection after 17 years! In my practice I see infections that arise on average 11 years after the original surgery! These are extremely complicated problems as antibiotics typically cannot resolve the infection, and the implant usually is a major supportive structure. This patient was on antibiotics for almost a year, that failed to clear the infection. She sought treatment from multiple surgeons who recommended removing the infected implant and allowing her to heal for 1 more year followed by a second surgery for definitive reconstruction. Looking at the intraoperative photos after implant removal you can appreciate the gravity of this approach. She would essentially have no nose for a whole year! I offered her implant removal with reconstruction during the same surgery.
Many times, patient’s are worried that implant removal will alter the shape of their nose. This patient was particularly worried because she liked her overall nasal appearance (minus the infection!). Fortunately, using the rib made her nose look even better, and I am pleased to say that she extremely satisfied with her results. Feel very fortunate and blessed to be trusted with a patient’s face.