What imaging will reveal the screws or plates used to hold an implant in rhinoplasty, and can another surgeon remove it?

Dear greyghost,Thank you for the question, I'm a little confused because I'm not sure if you had a CT scan alreadyIt is not uncommon for surgeons to omit details in their op reports. If you had a CT and the wire was not seen, then it's not thereIt's also a little odd that the k wire was holding the implant, and the implant was removed but not the plate or K wire.  I suspect that everything was removed based on your historyAgain, a CT scan after your last surgery would put any debate to restBest of luck,Dr NimaFacial plastic surgery

If the implants, plates, and/or screws are titanium, a simple xray or CT scan will show them. If they are all bioplastic, they usually absorb with time and tend to disappear on their own, even though they could leave behind scar tissue.

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  An x-ray should be able to detect if any metal plates or k-wires are still in place.  You could then be evaluated for a revision rhinoplasty.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.


Best wishes and good luck.


Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon
 

A simple CT sinus imaging study will reveal the plates and screws and obtaining the operative notes will help determine the company brand so your surgeon can match the plating system and the instruments appropriately if the hardware requires removal.  The K wire will 100% show up on the imaging. If there is nothing rewarding gained from the CT imaging study in the past I have ordered an MRI to evaluate other non-metallic implant materials such as gortex or silastic to determine the underlying problem for evaluation.  This may also be an option for you in the setting of a proposed revisional surgery.  In the absence of any concrete information you would then want to ensure that your surgeon is confident a revisional procedure will solve your concerns based on the unknown of what may or may not be encountered.  Hopefully this helps guide you through this challenging process!

Thank you for your question. You should be able to see a k-wire with a conventional X-ray. Certainly this will help when planning a revision rhinoplasty. Good luck.
Kind regards, 
GB

Dear greyghost, When you seek a revision rhinoplasty consultation discuss your concerns with your consulting surgeon. He/she can order an x-ray or any necessary testing before your revision surgery to help prepare a proper surgical plan. Best regards, Michael V. Elam, M.D.