Hard Bump Protruding at the Tip of Nose 2 Years After Rhinoplasty? (photo)

Question

I have a hard bump (size of a pimple but not a pimple) protruding at the tip of the nose 2 years after rhinoplasty. Feels like a bone/cartilage but my rhinoplasty involved using ear cartilage for the tip so I'm very worried if this is extrusion in the process. If this is so, what should I do? Can a small revision surgery be done to just remove the bit of bump at the tip? instead of removing the whole thing? Could someone please help advise? Thank you so much

Kenneth Hughes, MD · Answer

Antibiotics and drainage may help avoid removal of the implant. However, in the cases I have done, the implant needs to come out and the infection needs to be cleared. After several months, autologous grafts can be used to build back up the nose. Kenneth Hughes, MD Los Angeles, CA

Shim Ching, MD · Answer

From you photo, it looks like you have an infected cartilage graft. This is more commonly seen when silcone implants are used, but it is possible that your cartilage graft or related suture material has become infected. Antibiotics are the first line of treatment for your problem and you should start immediately. If extraction of infected material is necessary, it is a small procedure to do this. I would seek a surgeon experienced with rhinoplasty immediately. Best of luck and thank you for your questions.

Andres Bustillo, MD, FACS · Answer

The bump seems to be from an infection.The first treatment should be with oral antibiotics to see if it improves and resolves. If it does not resolve, the tip may have to be explored to see whether its a permanent suture thats infected or a synthetic implant.

Ahmed Abdullah, MD, FACS · Answer

It looks and sounds like an extrusion. However, without doing a physical examination, it's impossible to be sure. Assuming it is, a small excision can be performed to relieve the pressure at the extrusion point and possibly solve the issue.

	Your best advice is to see your surgeon immediately so this can be resolved.

	Good luck!

	Dr. A

Darryl J. Blinski, MD · Answer

First the infection and carbuncle needs to be cleared/opened/draine and use of antibiotics. After this clears than a revision tip rhinoplasty can be done to remove this area/piece of cartilage.

Peter E. Johnson, MD · Answer

If you do indeed have a silicone implant in the nose, infection can occur at any time, and often years after rhinoplasty. Antibiotics may reduce inflammation in the short term, however the implant usually must come out.

Edward Farrior, MD · Answer

If no foreign body was placed in your nose at the time of surgery, such as silicone, then the reaction you are having is most like from a stitch that was used to stabalize the graft that was made from the ear cattilage. When this stitch is removed and you are placed on the right antibiotics the bump should go away. If an alloplastic implant was used such as silicone then the entire implant must be removed. The best advise and care would come from your initial surgeon.

Richard W. Fleming, MD (retired) · Answer

From your picture I cannot tell if the bump is secondary to an irregularity of the underlying cartilage, a suture in the cartilage, or some reaction within the skin. An examination is necessary to determine the cause and recommend treatment. This can be corrected.

Thomas Guillot, MD (retired) · Answer

There appears to be an infection and the source needs to be determined.  A trial of antibiotics is warranted, and if no improvement is seen then an exploration will be needed.

Hard Bump Protruding at the Tip of Nose 2 Years After Rhinoplasty? (photo)

Answers (9)