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One Nostril Not Healing Properly After Rhinoplasty

I had Rhinoplasty done almost two weeks ago and I have noticed that one nostril is healing propertly, but the other is not. It can be seen on the picture that it seems to be open and has some blood in between. I've sent this picture and some other to my doctor, but the receptionist says it's normal and that I should put some Neosporin on it and it will get better.

However, I'm concerned because when I touch it, the nostril seems to be moving and open in half. I'm afraid it might heal open and I'll end up with a horrible scar. Is this normal, and will it heal properly? I don't know what to do, and I'm really afraid and frustrated now.

Doctor Answers 10

February 3rd, 2009

Let it heal

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It would be my advice and opinion to let it heal. An attempt at closing this "open" is not generally a good idea because one it is open, it may have a higher chance of becoming infected.

Letting it heal on its own with Neosporin as your doctor advised is a reasonable alternative. In the event that this produces excessive scar it can be revised at a later date when the risk of infection is low. Attempting a quick fix now may not ultimately give you your best result.

Otto Joseph Placik, MD


Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

December 10th, 2008

Dehisced alar base reduction

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The pictures seem to show that the incision of the alar base reduction on the left has split open. Such a problem is not "normal" and should be evaluated by your surgeon.

I would be leery of closing a dehisced wound at this stage, though, since the swelling could make it hard to precisely close the wound edges and the contaminated nature of such a wound could increase the likelihood of infection by closing it.

A reasonable approach for such wounds can include simply letting it heal in on its own and then revising the resulting scar--often a minor in-office procedure--several months later.

All the best,

--DCP

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon

December 4th, 2008

Stitches may have come out from nostril

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It appears that a stitch or two may have come out on one side too soon.  TIf this is the case then it  can easily be fixed by seeing your doctor and having it resutured.

Steven Wallach, MD

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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December 4th, 2008

Looks like your suture came out... sorry

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The suture has come out and the incision has separated. It it is detected immediately after suture removal, then it is easier to fix. The longer your wait, it may be best to let the swelling decrease and the scar to be revised at a later date (3-6 months later). This is something to be discussed with your surgeon. INSIST on being seen and I am sure they will see you. Then, the two of you can decide on the ideal plan for you.

Sirish Maddali, MD
Portland Plastic Surgeon

December 3rd, 2008

One Nostril Not Healing Well After Rhinoplasty

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Hi Poli,

It looks like the Weir incision made to narrow your nostril has opened.  It needs to be sutured.  If closed properly you should not end up with the "horrible scar" that you are worried about.  Good luck.

Dr. P

Michael A. Persky, MD

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

December 3rd, 2008

Stitches may have come out too early

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From your photograph it appears that you had a incision at the base of your nostril. This would have been done to reduce the width of the nostrils themselves. If this is the incision that opened up it may be due to a suture falling out. It is possible that you would have to wait until it is fully healed before the problem could be fixed. In any event it is something that your surgeon should see and advice you on how to properly care for it so that it heals satisfactorily

Jeffrey Zwiren, MD

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

December 3rd, 2008

See your doctor now to close the site

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It sounds like the wound is open and should be closed by your surgeon-at least it should be evaluated. I have never had this problem and it may have been caused by trauma to the area. Insist on being seen.

Toby Mayer, MD

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

December 3rd, 2008

The wound looks like it has opened a bit

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Your wound looks like it has opened a bit. It left to heal in on it's own the scar will be wider than the right nostril but probably not much. Going in to revise the open wound too early could really create a significant scar that is not easily correctable. Let it heal with good clean care and see how it turns out. It may look great and not need any revision, or it may just need a small in-office revision to clean it up. Either way do insist that you get seen by your surgeon so that he/she can actually see what the problem is and help allay any fears that you may have. Sometimes, office staff are a bit too protective of their surgeon's time to the detriment of legitimate patient concerns. Good luck and don't stress until you get all the facts about your particular situation.

Dr. Shah

Manish H. Shah, MD, FACS

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

December 3rd, 2008

ABR Separation

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You should call and insist on talking to your doctor. Your Problem is not unheard of, but atypical. It is also something that can be easily remedied when treated.
See your doctor and all will be well. Don't let the receptionist decide your care.

Robert M. Freund, MD

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

December 11th, 2008

Alar Base Reduction wound has opened

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It appears from your picture that your incision from an alar base reduction to decrease the width the base of the nose has opened up on the left side. I would definitely recommend you see your surgeon immediately for them to reassess the wound to determine if it needs to be revised immediately or at a later date. The earlier you present after this occurs the better the chance that you won't have to wait until later to get it fixed. This can occur after any alar base reduction and is a potential complication from any incision on any part of your face. Ultimately with the appropriate closure it should heal well without likely permanent problems.

Samson Lee, MD
Seattle Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.