Can Stitches Still be in my Nose 5 Years After Rhinoplasty?

Question

1)I had my nose done 5 years ago by Dr.Gary Friedman in SF.He's now out of business.Since the surgery I have a big bump/growth inside of my left nostrill,it looks like cartilage but lately it's getting much bigger!What is this? 2)Also when I touch the inside of my nose kind of by the tip,I feel something short and sharp that feels like stitches.This never went away since the surgery.Why would they leave parts of the stitches in? What to do? Thanks for your help!

Umang Mehta, MD · Answer

Both dissolvable and non-dissolvable sutures are used inside the nose during a typical rhinoplasty. Occasionally one of the non-dissolvable or permanent sutures used in the nose can work its way through the inner lining of the nose. When this takes place, the best course of action is to have a plastic surgeon remove the stitch. This can easily and safely be done in the office and the shape of the nose should not be affected. As for the "bump" inside your nose, you should have your nose examined by a rhinoplasty surgeon. It is difficult to speculate as to what this is based on the photos you have uploaded. 

	Best,

	Dr. Mehta

Jeffrey J. Roth, MD, FACS · Answer

What you describe can be the leading edge of the cartilage, which can "settle" or move with time. there may bell be a stitch that works its way out to the surface with time as well. Often Rhinoplasty doctors will place permanent sutures to help shape the nose. Other things can be a granuloma, although this is more rare. Best to see a qualified, experienced rhinoplasty surgeon and have it addressed.

Amy T. Bandy, DO, FACS · Answer

Unfortunately your photo is not clear enough to tell what your problem is. The suture material that you doctor used could have been a permanent stich, which over time can poke through the mucosa. This is not the only explanation though, and you really should be evaluated if you are feeling something sharp. Good luck!

Toby Mayer, MD · Answer

Yes, it could be but is unlikely. You need to see a rhinoplasty surgeon in your area and let him look inside your nose and see what is going on.

Steven J. Pearlman, MD, FACS · Answer

Choice of suture (stitch) material in rhinoplasty depends on the surgeon. Some use non-dissolving stitches for the tip cartilages. Very rarely, these stitches can migrate or poke out through the skin. To avoid this, knots should be buried under the cartilages and they should't be used near incisions. Personally, i feel that using dissolving stitches that last a few months is sufficient to obtain long lasting results. Over the two to four months that it takes these long acting dissolvable sutures to dissolve, healing and scar tissue is sufficient to keep things from shifting any further in the future.

	If there is tenderness and/or swelling that occurs months to years later, you should have someone check to see if either a non-dissolvable stitch is poking out and needs to be removed. Sometimes even small implants may have been used that need to be addressed as well.

Paul E. Kelly, MD · Answer

Hey Kamila - the bump you are feeling in the nose is most likely the leading edge of one of the cartilages found in the tip of the nose - when this area is trimmed the nasal tip is thinned and if the incision site is not closed it is possible for this structure to prolapse or fall. As the nose matures this may also happen and can even become a bit worse until it levels or completes the settle process. I agree with others who indicate that it is not terribly uncommon for an inside nasal stitch to migrate or extrude towards the outside skin - while uncommon it is easily remedied by simply seeing your surgeon back who will remove the stitch definitively. If your primary surgeon is no longer in your area than anyone who has experience in nasal surgery can help!

Darryl J. Blinski, MD · Answer

All the other expert posters have discussed the possible causes, I recommend seeing a rhinoplasty surgeon for removal under local anesthesia. If just a suture than no issue. If a edge of cartilage have it repaied. But if a "growth" like a pyogenic granuloma you need excision and suture and pathology. Best of luck go get this taken care of. From MIAMI

Mohsen Tavoussi, MD, DO · Answer

The bump you feel and is visible in photographs is edge of the lateral cartilages and are normal after this type of surgery. The suture, if there is one, may be a permenant suture used to refine the tip cartilages. Recommend seeing a rhinoplastic surgeon for definitive diagnosis.

Erel Laufer, MD · Answer

It can be stitches or any other foreign body .Please, go and see another plastic surgeon  to look inside you nostril and take care of it.

Steven Wallach, MD · Answer

It is always helpful to see an op-note and even though tthe guy is retired, by law he is supposed to keep your records for at least 7 years. You may still be able to obtain them. This may help the "next guy" to figure out what is going on. Most likely you are seeing a cartilage graft or possibly septum in the left nostril. Sutures usually dissolve, although some surgeons were using permanent sutures in the past.

Can Stitches Still be in my Nose 5 Years After Rhinoplasty?

Answers (13)