What Are the Advantages and Disadvantages of Immediate Repair from an Infected Rhinoplasty?

I had Asian rhinoplasty w/goretex & ear cartilage tip June 2011.I hav infxn 1 month now. It started as pimple on right part of nose & has been producing pus.I consulted DR & he cleaned infected part & said implant is stable & put me on antibiotic therapy.Today,I saw DR he said he can do imediate repair.Upon removal of infected goretex,he can put a fat tissue from my butt & put a new goretex.Any thoughts?What are dis/advantages of imediate repair in comparison to waiting for a few months to heal?

Doctor Answers (5)

How to deal with an infected nasal implant

+2

With my Asian patients I do not use implants (I use septal and/or rib, and/or ear cartilage) so I don't have a lot of experienced with infected nasal implants. But I have taken care of patients with problems similar to yours who have come to me for help. With that said the plan to remove an implant, wash it out, add fat and put another implant seems unusual to me. You might ask your surgeon to explain the strategy to you and you might ask has he/she done this in the past and more importantly was it successful.

If your were to visit me. I would likely take it out. Let your tissues heal/recover for at least 3 months then repair the damage with rib, not another implant.


Austin Plastic Surgeon
5.0 out of 5 stars 32 reviews

Infected Asian Nasal Implant

+2

Unfortunately you are not alone.  This is common with Asians who have had implants placed.  Generally the implant is removed as soon as possible, the entire area is cleaned out with antibiotics and you are allowed to heal before fixing the area to give you time to clear the infection.  If a new implant is placed before the infection is cleared, it will again be infected.  Please consult with a board certified specialist who can assist you with this.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Immediate vs. Delayed revision of a goretex implant Asian rhinoplasty

+2

Hello mommah88,

I'm sorry for your troubles.  You definitely have a difficult choice to make.  My concern with your situation is that it can be very difficult to sterilize a Goretex implant.  Removal of the implant if it is not completely sterile may leave bacteria inside your nasal tissues.  Adding a non-vascularized material like a fat graft could provide a food source for the remaining bacteria.  This would put your new implant at risk of getting infected all over again.  Also, infected tissues often have a tenous blood supply making healthy soft tissue coverage less likely.  The tissues can be less mobile and less forgiving to handling during surgery.  Unfortunately I have not seen or felt your nose, so I can not tell you with any reasonable certainty that you are contemplating a risky procedure.  I would get a second opinion in your home town from an Asian rhinoplasty expert to make sure that both surgeons concur.  If opinions differ, it may make more sense to remove the implant and let the nose settle down.  Once the environment is more hospitable, then you can re-implant with Goretex, silicone, or DCF (diced cartilage-fascia) graft.

Good luck and I hope all works out for the best.

Dr. Shah

 

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
5.0 out of 5 stars 19 reviews

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What Are the Advantages and Disadvantages of Immediate Repair from an Infected Rhinoplasty?

+1
   If there is an infection present, the implant should be removed, antimicrobials should be administered, and the area should heal for a period of time.  At a later date, alterations can be made.
Kenneth Hughes, MD
Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
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Infected nasal implant - a real dilemma

+1

It is difficult to say what to do without the benefit of an examination.  I would ask your surgeon if the implant is infected.  If it is, it needs to come out.  If it is a skin infection with no implant involvement, then there are other options.  I would think that putting a new implant in when there is infection may be a problem since the infection will probably affect the new implant.  Again, you have to ask you surgeon and be evaluated.  Good luck!

Jay Calvert, MD
Beverly Hills Plastic Surgeon
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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.