Why Does my Nose Turn Red Every Afternoon After Revision Rhino?

Question

Hi - I had a revision rhinoplasty 2 years ago. I have a very strange situation - every afternoon, my nose turns red, throbs, feels warm, looks swollen, and I feel congested. This lasts for about 1 -2 hours. It happens regardless of what I eat for lunch, regardless of what I drink. I have been evaluated by dermatologist and do not have rocasea, I do not drink alcohol, I use fluticasone nasal spray daily and take an oral antihistamine daily. Any thoughts on what this could be and any treatment?

Kevin M. Robertson, MD, FACS · Answer

A chronic inflammation or intolerance of an implant is the first thing to rule out. Your surgeon should be able to tell you if there was any foreign materials used during your surgery. The second is generalized injury to the skin/soft tissue envelope of the skin after multiple surgeries. Each time you have a surgery the vascular and lymphatic vessels of the nose will be challenged, and you may end up with permanent consequences. Vascular inflow or outflow may be impaired causing blanching (esp with cold weather) or congestion, or propensities to hold swelling for long periods of time from damaged lymphatics. Finally, skin conditions such as rosacea must be considered, even if your derm feels they are not likely. All things to continue to bring up with your doc, even two years out.

Steven Wallach, MD · Answer

Without having more of a history,  it is difficult to say what could be the cause. If you had a graft placed it may be infected.  You should see your surgeon to be properly evaluated.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

My first question to you is: Did your surgeon use any implant material in your revision? If yes, what kind? You can have a slow, indolent infection from even a small amount of implant material. If not, (and your sure it's NOT) then you may want to get an MRI of your nose.

Best,

Dr.S.

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