Hard Red Bump (Or Inflammation) Inside Nostril on Columella Sticking Out. Is This Permanent? Easy to Remove? (photo)

Hello,

 

Although your photos are blurry and small, what you are expressing may be a suture abscess or an epithelial cyst but highly unlikely an infection.

I encourage you to follow your surgeon's instructions religiously and let nature take its course. Please bear in mind that you are at 2 months post-op and your nose should be almost 40% healed.

If the antibiotics did not work, corticosteroid injection may be of a certain help to your situation.

I hope this helps.

Thank you for your question.

The best of luck to you.

Dr. Sajjadian

I see this a lot. It can be from many things. It can be a retained suture, protruding cartilage, scar, cyst and many other things. Without actually seeing it I can not really tell you which one it is. I do agree it is likely not infection. It sounds like your surgeon is giving you good advice. Usually these things do resolve over the course of 6 months to a year. Only a person actually looking at this area and watching it for you can tell you what is best. Keep an eye on it with your surgeon.

Redness and bumps are not uncommon following rhinoplasty, though they usually resolve by the 1 month visit.  The red bump shown in the photo at 2 months is a little unusual.  I tend to agree that it is likely not an infection, but it's impossible to tell from just a photo.  In addition, the incisions for an endonasal rhinoplasty often don't extend to that area (though they can, depending on what is done during the procedure)


I recently did have a patient with soreness and redness at the columella 1 month following the surgery.  He essentially asked the same question you did.  As it turns out, that patient had a habit of "flicking" his nose/nostrils with the side of his fingers.  This was causing the incisions to remain red and irritated.  

 

It sounds like you're doing the right thing--trial of antibiotics, tincture of time...The one other thing to try is a small steroid injection to see if that calms the irritation down.  

Yes the posted photo shows either a suture retained abscess. Or epithelial inclusion cyst that is inflamed. I recommend excisional removal. 

Lots of possibilities: Folliculitis, stitch abscess, local traumatic irritation, impending graft extrusion (hope not), epithelial cyst, topical drug reaction, acne breakout, etc.  See your surgeon again and another Cosmetic Surgeon if necessary.