Nose tip red, foul smell, sore, headachy, no fever - prescribed meds 9d ago - surgeon says it's fine - what to do? (photos)

Question

Firstly, I speak to my surgeon every couple of days, saw her only 3 days ago, and additionally send her photos nearly daily - I'm a worry wort, I admit. Have been on Biaxin 9 days, am allergic to Ceclor. 1st rhinoplasty, no implants, cartilage is from my own septum. Have foul smell, sore achy nose, and now that casts are off (just taping each night), I can finally see how red the tip is. It all worries me. What should I do? Is this normal? Should things start getting better soon?

Stephen Prendiville, MD · Answer

What the photo show is definitely not "normal" after Rhinoplasty.  Although an examination would provide definitive information, the redness is suggestive of an infection.  Such infections, although rare, are usually related to some form of Staphylococcus.  Biaxin is not an adequate medication for this type of bacteria, usually only covering respiratory flora. A medication such as Doxcycline, or Augmentin would be more beneficial in such a scenario.  Go and see your Surgeon today!

Alejandro Nogueira, MD · Answer

This is very rare complication, are you sure nothing alloplastic (artificial) was inserted in your nose? this infectious outbreak I've never seen in 20 years doing rhinoplasties using own patient's cartilage.Needs immediate intervention to drain the abscess and remove the source of infection.

Vincent N. Zubowicz, MD · Answer

From the photograph something is definitely a mess. The amount of redness is something I've not seen before and may be suggestive of a deeper infection. I would report back to your plastic surgeon and have him check it again.

Chase Lay, MD · Answer

You need to get to your surgeon right now. And if you're certain won't see you right now and you go find one that will because this is an infection until proven otherwise. It is very rare for cartilage graft to become infected after a classy but it can't happen.  get to the doctor right now. You will most likely need to open this and clean out or washout pus and other infected debris .Chase Lay MD

Fred J. Bressler, MD, FACS · Answer

I share your concerns about your post-operative appearance, foul smell, painful nose, redness and swelling. You need an examination to check for a post operative infection or nasal abcess. This is not a normal finding! Please see your surgeon immediately, as nasal access requires surgical drainage.

Michael T. Somenek, MD · Answer

It would be helpful to know how long ago your rhinoplasty was. Either way, the redness seems far more than what I would consider "normal" in the postoperative period. I would recommend seeing your surgeon in person, especially since you have been on antibiotics for 9 days and it doesn't appear to be improving. Best of luck.

Sachin S. Pawar, MD · Answer

Your nasal tip looks much more red and inflamed than I would expect at this point. Although your nose will be swollen, the redness could be a sign of infection or even possibly a reaction to the tape. If it is not improving or worsening, I would encourage you to follow-up with your surgeon in person for an evaluation. Good luck!

Michael Elam, MD (retired) · Answer

Dear vintagezen, This is absolutely not normal and needs immediate care. I would be a "worry wort" if I ever saw this on one of my patients without doubt. This needs immediate treatment I would suggest a secondary opinion asap if your surgeon does not change your course of action today. I definitely would not be taping your nose at this time you appear to have a serious infection. See your surgeon today!!! Best regards, Michael V. Elam, M.D.

Robert E. Zaworski, MD (retired) · Answer

You have every reason to be concerned about your nose.  Please contact your surgeon as soon as possible as it is obvious your have an infection.

Nose tip red, foul smell, sore, headachy, no fever - prescribed meds 9d ago - surgeon says it's fine - what to do? (photos)

Answers (9)

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