How Long Do I Have to Wait After Taking out Infected Nasal Implant Before I Can Have Revision Surgery?

If your own rib cartilage is being used for the reconstruction it is typically OK to remove the infected silicone and use rib cartilage at the same time

I recently treated a Phillipina patient that had an infected silicone implant in the bridge of her nose, without removing the implant. She presented to my office with a painless red swelling on the bridge of her nose many years folowing Rhinoplasty Surgery in the Phillipines. She had a localized abscess (collection of pus) that required drainage twice in the office; and she required a full month of antibiotic by mouth.

I advised my patient during our initial consultation that removal of the implant would be necessary if these conservative measures were not successful in eliminating her nasal swelling, redness, and purulence.

If you need to have your implant removed, this should be done as an isolated procedure. When your infection resolves,and and when your post-surgical swelling is gone, you can decide what to do. If your bridge needs to be raised, you could consider a Non-Surgical Rhinoplasty with Injectable Fillers. My personal preference is Silikon-1000 for permanent results. Silikon-1000 does not work well for projecting your tip.

If any of my colleagues wish to learn more about my experience with Silikon-1000, I am giving an instructional cours in Boston at the upcoming Fall Meeting of The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). The course is titled "Off-Label Applications of Liquid Injectable Silicone (LIS)", and I will be presenting on 9/24/2010 at 4pm. Common conditions treated include: volume replacement, wrinkle reduction, lip enhancement, acne scarring, and correction of many nasal irregularities (“Non-Surgical Rhinoplasty”). I will also be describing the serial puncture, microdroplet technique that is essential for achieving desired results.
 

All the best from NJ.

There is great controversy in regards to this topic and it is likely you will get several different opinions. Obviously getting a rib graft is a major surgery and you want to do this under optimal conditions. Once a graft is removed, it is essentially dead and depends on the recpient site for blood supply. If that site is contaminated the graft could become infected. Some would immeadiately replace the cartilage with graft, but in my opinion, I would wait for a minimum of 3 months and possibly use antibiotics based on cultures taken from the  procedure.

It is important to wait a year after the resolutions of any redness and infection prior to undergoing extensive rib cartilage grafting to the nose. The last thing you want to have happen is for the rib cartilage to get infected and that will have to be removed.

If you truely have an infected nasal silicone implant, it should be removed immediately. You DO NOT leave infection simmer with a foriegn body infected.

Resurgery after that depend on the healing. Once completelt healed, you need to wait 3-6 months.

I strongly lean toward a RIB graft because it will resist infection better than any foriegn body.

The treatment of foriegn body infection is removal of the foriegn body and continue treating the infection with proper antibiotics, depending on the result of the culture.If the infected foriegn body is not removed , the infection will come back. It is not heroic to salvage an infected foriegn body for the infection to come back some other day

Rule of thumb is 3 to 6 months. But there are always additional issues to determine when a revisional operation can be done. Please consult with the chosen surgeon in detail.

From MIAMI Dr. B

If you need to have your silicone implant removed from your nose so that your infection heals, I would sya that you would probably have to wait about 1 year to have a revison performed.  You really have to wait until the soft tissues...well..soften.

Assuming you have removed the implant, I would wait at least 6 months after treatment of the infection to have revision surgery. I would not remove previous cartilage grafts which can be used during your reconstructive surgery. We usually recommend using the patient's own tissue in augmentation rhinoplasty because your experience with implants is not rare.