Pain and Numbness After 3 Years of Rhinoplasty? (photo)

It is unusual to see symptoms like this so long after surgery. One exception is in the case of an implant having been placed in the nose.  I see that you are Asian and you have a fairly defined bridge which causes me to wonder if you had an implant placed to augment your bridge and/or tip previously.  If this is the case and the pain is focal and getting worse, it could mean that your body is reacting to the implant. If the skin becomes red over the implant, if there is discharge or if there is a break in the skin, these are more alarming signs of implant infection.  I would definately get an appointment with your surgeon or someone who is familiar with Asian rhinoplasty.  If the implant becomes infected, in my opinion it would need to be removed and likely replaced with a rib cartilage graft large enough to provide as much augmentation as the implant.  If I am wrong about the implant, then I do not have a good explanation for your symptoms.  Either way, go see your surgeon!

Hello! Thank you for your question! Numbness after any surgical
procedure is expected for several weeks to months following. As the
nerves to the area are traumatized and will then experience a temporary
neuropraxia, a transient loss of nerve conduction. This usually
resolves over the next 6-12 weeks, but depending on the procedure
performed, sometimes much longer. Typically this should resolve by 1
year. As it goes past this date, the likelihood of the sensation
returning is small. However, it can take up to 2 years. If no return
from there, it is unlikely to return. It should be discussed that
persistent sensory changes may develop following any surgical
procedure. The usual signs of the nerves regenerating and neuropraxia
resolving is itching, followed by a burning sensation and then
occasional sharp, shock-like pains. These will be normal to experience,
and actually a promising sign. Usually, normal sensation returns, but
is is also possible to have decreased sensation or even increased
sensation to the areas affected. Re-educating nerves postoperatively is
often helpful and will allow proper instruction for the affected
sensory nerves - methods include using different textures to the
affected areas when showering, bathing, applying lotion, etc. If
bothersome, there are some medications that may be helpful, including
Neurontin for pain for hypersensitivity. You can try various textures
such as washcloths, loofahs, cotton sheets, etc. Massaging the areas is
also beneficial for the incision to make the finest scar possible. The
last place to regain the sensation will be directly adjacent to the
incision/scar as the nerves will make its way from the periphery to this
location. If continual pain arises, evaluation is warranted. After
ruling out other causes, one rare explanation may be that a neuroma has
developed and may require surgical excision. This is very unlikely
unless a large sensory nerve has been transected inadvertently during
the procedure. Hope that this helps! Best wishes!

Dear Ling,

 

Pain and numbness at 3 years post-op are not normal symptoms. So, I recommend that you have your surgeon take a look at your nose and examine the area of matter.

If you had a silicone implant then what you have experience may be the start of a rejection process that requires immediate attention before things get worse and then you will be obligated to undergo surgery to remove your nasal implant.

I believe an antibiotic treatment could be a good start to rectify the situation.

I hope this helps.

Thank you for your inquiry.

The best of wishes to you.

Dr. Sajjadian

Pain and numbness are not normal 3years after rhinoplasty so see your surgeon. He can evaluate your symptoms. 

In general, almost all noses are numb right after a rhinoplasty. In most cases its the tip that is numb, but this numbness can extend down to the upper lip, and in rare cases some of the teeth. It is also not uncommon that one side of the nose is more numb than the other. There are nerves that are cut and stretched during a rhinoplasty, and it takes a long time for those nerves to start working again. This is true of an open as well as closed rhinoplasty, although it tends to be more extensive in open rhinoplasty. This could also be more extensive if a septoplasty is performed at the same time. This, along with the swelling, gives you a stiff, plastic type feel, and can give you an odd smile. However, the nerves will start working and again, and your nose stiffness will go away with time. This takes in most cases months, but can take years in rare cases. Extremely rarely, the numbness is permanent, although I have never seen such as case.  In certain cases where an implant was used, numbness could be caused by compression against the implant, or if it happens years later, then an infected implant can cause numbness as well.Best Wishes,Pablo Prichard, MD