Surface Infection One Year After Rhinoplasty

Hard to be sure not knowing what maneuvers were performed during your rhinoplasty, but this likely represents an infection of the cartilage graft or sutures used to secure a cartilage tip graft during the original surgery.  In order to lengthen the nose, a tip graft was likely carved from the ear cartilage and sewn onto the end of the existing lower cartilages.  The site of your infection corresponds to the usual suture placement used to secure tip grafts.  If a permanent suture was used, then this may have become infected.  Alternatively, the cartilage graft itself may have been left too bulky in this location.  Either way, I would recommend oral antibiotics and careful exploration of the site which could be done under local anesthetic as an office procedure.

This appears to be an infection in the cartilage graft and overlying skin. After 1 year, this probably started as an area of breakdown in the skin over the graft, perhaps from pressure, irritation, or thin skin that just allowed bacteria in. Infection starting in the graft or sutures would have presented itself earlier, causing the skin breakdown rather than the other way around. At any rate, now things look the same--skin breakdown and infected cartilage graft beneath with persistent drainage. This will not get better on its own!

You should see your surgeon immediately for culture and antibiotic therapy that can be adjusted if the cultures require. You may lose a portion of your graft, but after 1 year there should be enough stability in the reconstructed nose to maintain appearance. A small touch-up procedure could be performed once all is healed if necessary for optimal improvement.

This is an infection until proven otherwise; please call your surgeon today!

I read your concern and reviewed your photo. Recurrent infection with purulent drainage at your left columella is likely originating from a permanent suture that might have been used to anchor your ear-cartilage graft in place. If that's the case, you would benefit from seeing your surgeon for evaluation and possible suture removal which could resolve the situation. Also, your surgeon could obtain a specimen for culture and consider a trial of oral antibiotics.

Ask your surgeon if any foreign-body materials were used to reconstruct your nose.

I hope this is helpful for you.