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Bizarre Recurring Swelling in Last 3rd of Nose with Nasal Implant

I had a small silicone nasal implant inserted to help breathing and increase dorsum about 13 months ago. About 2 months ago I woke up with the last 3rd of my nose swollen for no explicable reason. The tip of the nose hurt, and the pain (redness) spread to my nose bridge. Surgeons/ENT say its not an infection, and bridge is probably implant pushing against it. Swelling in last 3rd is still coming and going after 2 months, even though overall I am much better. What could be causing this swelling?

Doctor Answers (9)

Recurring Nasal Swelling after Implant

+1

After nasal implants there is a risk of implant movement or extrusion. Infection is possible, even a long time after surgery. Any of these complications may cause your symptoms. You need careful evaluation, especially when you're having problems. Implant removal may be necessary.


Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Nasal impant problems

+1

It sounds like you do have an infection. Infection with nasal implants occurs in about 10% of cases and may require its removal. Watch my videos!

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 23 reviews

Implant and intermittent swelling

+1

Dear Miami982,  thanks for your question - although I have no pictures to review, the swelling in your nose a year after surgery and in particular swelling associated with redness and tenderness is clearly an infection.  When an implant such as silicone is placed under the skin, the body will actually wall off this implant from the rest of the environment.  If the capsule should break or tear from for example trauma or any shearing motion, the site can be seeded with bacteria.  While I don't use plastic at all in the nose, many would suggest that a course of a good antibiotic - one that covers staph and pseudomonas (two common bacteria) will circumvent the requirement for removal of the implant.  If the site continues to fluctuate despite the antibiotic then removal and a 3-6 month waiting period prior to re-augmentation may be indicated. Hope this is helpful - peconic-faces.com

Sincerely,

Dr. Kelly

Paul E. Kelly, MD
Hamptons Facial Plastic Surgeon
4.5 out of 5 stars 2 reviews

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Implants and rhinoplasty

+1

A red swollen nasal tip to me is more than likely the implant possibly being infected. It osunds like it may need to come out, but I wouldn't be sure without an exam.  Follow closely with your doctors.

Steven Wallach, MD
Manhattan Plastic Surgeon
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Problems with synthetic implant placement in rhinoplasty

+1

Synthetic implants in the nose (e.g. silicone implants) can be associated with issues such as extrusion (the implant coming through the skin), migration (movement under the skin), visible edges, and infection. The appropriate intervention for these situations varies from antibiotics to repositioning or shaving the implant to even removing the implant completely. 

A thorough examination of your nose would be needed to determine the cause of your symptoms. You should readdress the issue with your rhinoplasty surgeon and see if she/he thinks that your implant needs to be removed. You may be a candidate for placement of cartilage from your septum, ear or rib to augment your bridge instead of the synthetic silicone implant. 

Best,

Umang Mehta, M.D.

Umang Mehta, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 29 reviews

Infection of nasal implants

+1

Dear Rhinoplasty patient from Miami,
The most common complications associated with nasal silicone implants are infection and extrusion. If you have been treated with antibiotics and getting better, less redness and swelling, it may be fine to leave the implant in place. However, persistent discomfort and redness are indications of chronic infection and unfortunately in this case the nasal implant must be removed. Good luck and good healing
 

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 101 reviews

Swelling after nasal implant

+1

You do not say, but I assume you have been on antibiotics. if you have continuing redness, swelling and discomfort despite antibiotics, your implant is most likely infected and should probably need to come out. An implant pushing on the skin would not cause redness, it would actually blanche.

Jack Peterson, MD
Topeka Plastic Surgeon
5.0 out of 5 stars 15 reviews

Nasal Swelling After Silicone Implant

+1

The big issues with nasal implants are infection, migration and erosion through the skin.  Without a photo or exam there is no way to know what is going on with you, but I think one of these might be in play.  Redness and pain are often a sign of infection, and this can result from a migrated implant that is now pushing on the skin - or even a simple implant infection.  However, the vast majority of these don't improve on their own.  Either the chronic infection forces the removal of the implant or the implant can erode through the skin.  There are chances that a course of antibiotics can rid you of the issue, but this is less commonly the issue.  There could be a reaction from the tissues relating to a chronic seroma (fluid) that is causing you the intermittent swelling, but this can lead to an infection of not properly drained.

Se your surgeon and have this evaluated in person.

Best of luck

Vincent Marin, MD, FACS

San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 26 reviews

Swelling after silicone implant

+1

It's likely that it's your implant pushing against your skin as the other surgeons/ENT's you've seen have suggested.   It's hard to give any specific advice without seeing you in person. However, I would recommend you speak to your rhinoplasty surgeon about your concerns and whether you'd be a candidate for a revision if it's really bothering you. I'm sure he/she would be happy to talk to you to answer you questions.

 

Dr. Cat Begovic M.D.
 

Catherine Huang-Begovic, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.