Do I need a second brow lift and rhinoplasty after 17 years?

Question

Back in year 2000, I had a brow lift and dorsal nasal augmentation. After more than a decade, it has been causing me some discomfort. I understand that the nasal implant would inevitability migrate upward and therefore cause some discomfort. I am also experiencing some discomfort on my scalp from what I believe to be the brow lift fixation system. My memory may not serve me well but I believe it involved cortical tunnel fixations. Any help recommendation or insight would be appreciated.

Deepak Raj Dugar, MD · Answer

Hello,
I recommend that you see a doctor if you are having discomfort so many years after surgery. Consult a board certified plastic surgeon that dedicates 100% of his time to rhinoplasties for the best advice on what to do and why the pain is being caused. 
Best of luck!
Deepak Dugar, MDScarless Rhinoplasty ExpertBeverly Hills, CA 90210

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. It would be helpful to see photos of your before and after, and to learn more about your discomfort because it will allow us to provide better advice. Nasal surgery can repair any structural issues and improve the appearance. It is important that the result of your rhinoplasty be both symmetrical and proportional so I suggest that you move forward and consult with a board certified facial plastic surgeon.
Best wishes,

Vasdev Rai, MD · Answer

There is no way to answer your question without seeing you in person. You should also get your old records prior to seeing another plastic surgeon.

Kristina Tansavatdi, MD · Answer

Discomfort is a broad descriptive term. Could you elaborate? Some other information you may want to obtain is the type of nasal implant that was used. Was it soft or firm? There are many types of implants but the most typical implants used 17 years ago would have been Goretex or silicone implants. In regards to the cortical tunnel fixation system, the tunnels themselves rarely cause pain or discomfort so many years out. However, permanent sutures may have been used to secure the scalp through the tunnels. Permanent sutures rarely cause problems so many years later with pain. Rather you may have extrusion or granuloma formation. I would rather consider possibility of a low grade infection/reaction around the dorsal nasal implant that is in place. Any infection can seed the surface of the implant and lead to cellulitis and even infection towards the eye (orbital cellulitis) and into the brain. This is not meant to alarm you and in no way am I diagnosing an infection. I recommend you visit with a facial plastic surgeon to have an in person examination.

Do I need a second brow lift and rhinoplasty after 17 years?

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