I had revision Rhinoplasty in Nov. 09. I didn't think my doctor had used a implant in the bridge of my nose. For the past year I have not been feeling well. I have had symptoms such as terrible odor of the nose, mouth and ear pain, jaw, facial swelling & now the huge red hump on the nose. Found out implant is in there on a CT scan. How difficult is it to remove a infected Gore-tex implant? What approach is recommend? Open or close? Thanks so much?
Infected Gore-tex Nasal Implant
Doctor Answers (12)
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You need to see a good Rhinoplasty Specialist ASAP
You need to see a good Rhinoplasty Specialist ASAP. You need long term antibiotics and potentially I.V. antibiotics. The implant most likely will have to be removed and then the area allowed to heal followed by another surgery 6-12 months later to use cartilage to build the area back up if necessary. The problem with implants in the nose is that they can become infected even 20 years later.
Infected Gortex nasal implant must be removed
If the Gortex implant is infected it must be removed immediately. Nothing good will come of leaving an infected implant in place. Once infected, the implant will only continue to smolder in infection and antibiotics will not cure this problem. The implant has to be removed. This can be done either through open or closed rhinoplasty techniques, whichever your rhinoplasty surgeon is the most comfortable with.
Web reference: http://www.seattlefacial.com/internet_consultation.html
Just get the infected implant out with the least scarring possible
I hope that you have been treated already. These are the principles:
If any nasal infection has not come through the skin, have the implant taken out closed--much less dissection or chance of spreading the infection.
Even if the infection is draining through the skin, I would still limit dissection and remove the implant from the inside. Then let things heal--probably a year, and get your reconstruction done, unless you have just had enough. I do not use artificial materials in the nose for exactly this reason.
This type of surgery is very successful but must be done by someone who performs revisionary rhinoplasty often. Find a surgeon whom you trust and who can show you results of other patients with similar deformities that you like. Good luck!
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Gore Tex Infected nasal implant
It's not difficult to remove the Gore tex infected nasal implant and this should be done, IMHO, ASAP as the infection could spread and create serious health issues. Please see someone about this immediately.
Web reference: http://www.drfpalmer.com
The infected implant should be removed and replaced with a rib cartilage graft at the same time. Removal of the implant can be done closed but the rib graft requires open approach.
Web reference: http://www.seattlerhinoplasty.com/html/index.php
Infection with gore-tex
You do not have much of a choice at this point. If your implant is infected it should be removed as far as the approach it depends on how it was placed initially and the size of the implant.
Infected Gortex Nasal Implant
The Gortex implant should be removed and oral antibiotics taken. I suggest having an MRI to make sure there is no infection of the bone. if there is any osteomyelitis, IV antibiotics will be necessary. It will be 6-9 months before you can have any revision surgery.
Removal of infected nasal implant
Typically, the nasal Goretex implant can be removed via an endonasal (closed) approach. Your surgeon should have the skills to avoid injuring the overlying skin during the removal. Overall, the removal is relatively straightforward but it depends on the level of scar that has developed around the implant and how big the implant pocket is. All infection must be cleared prior to reconstructing your nose, and swelling must subside as well. Six to twelve months is typically a good time to wait. Being that you already had a bad response to an implant, then cartilage from your own body (rib) would likely be the best material to replace the implant. Make sure you find a surgeon who is skilled and committed in revision rhinoplasty and rib grafting. Ask to view many before and after photos. I would be happy to provide you a comprehensive evaluation. Good luck!
Web reference: http://www.bwfacialplasticsurgery.com
Infected Gore-tex Nasal Implant Removal
An experienced rhinoplasty surgeon is needed for these cases. The implant should be removed and time should be allowed to pass to allow the nose to heal thoroughly and the infection to clear before attempting another procedure. I usually recommend 6 months before returning to surgery in such cases.
If another procedure is desired after 6 months, a natural implant such as cartilage from the septum of the nose or the ear could be considered.
Infected Gore-Tex (ePTFE) nasal implants may be removed using a closed rhinoplasty approach.
I read your concern. You should consult a reputable, certified rhinoplasty specialist regarding your situation as soon as possible. You can see a list of local certified specialists at abfprs.org.
You may be a candidate for oral antibiotics and local drainage if you have an abscess. If conservative treatment is not indicated, or if it doesn't help you, you should have your ePTFE implant removed. You would be best served by a rhinoplasty specialist that's removed Gore-Tex before. I've removed ePTFE using a closed rhinoplasty approach: through bilateral inter-carttilaginous incisions. I prefer an open approach for rhinoplasty surgery in general, but removing an implant may be performed transnasally. Removing Gore-Tex has been challenging in my personal experience. There is extensive tissue ingrowth, so it doesn't slip out like a silicone implant might.
All the best to you.
Regards from NJ.
Web reference: http://nosejobphotos.com/
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.
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