Can an implant become infected almost two years post op? (Photos)

Question

Context for my concerns: had a rhinoplasty in Vietnam, Dec 2023. Used surgiform for nose bridge and own ear cartilage for nose tip. I was quite happy with the result from 6M to 1Y. After 1Y mark when most of swelling went down I noticed more predominant swelling on my right middle nose bridge, tender to touch but disappeared after few months (brushed it off for uneven swelling). After this I had looked inside my nose and noticed a ?polyp which would bleed when cleaned and would cause a lot of boogers. I went to my GP which recc me to use mupurocin for two weeks. This did not help much. Over the past 6 months I have noticed my nose is less defined, becoming bolbous and swollen on sides, not painful or red. Past two weeks I have had two pimples on my nose bridge which are going down now (unsure if related). Today I woke up and cleaned the nostril to clear congestion, pus started to spill from this ?polyp area. I have a GP appt booked & ENT appt for next month. I can’t contact my plastic surgeon to discuss and am worried about what this may be, ?infected sinus, ?infected implant, ?why now. I’ve been struggling with low self esteem and anxiety about my appearance, pls if any professionals can provide insight on my situation and what the best steps to take are.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Synthetic implants can definitely get infected in the long-term postoperative results. You should definitely be seen by your plastic surgeon. You may also want to consider steroid injections separately from this. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Waleed Ezzat, MD, FACS · Answer

I'm sorry you are experiencing this.  Silicone implants are very common in Asia - this is due to a number of factors.  While the implants can produce predictable results in a variety of hands, these implants have up to a 20% failure rate over the life of the implant.  In fact, the longer the implant remains, the higher the incidence of implant rejection.  I would be very concerned that this may be happening with you.  Best move is to find a specialist with extensive experience in salvage rhinoplasty from implant failure for a full exam.  (There are nuances of the procedure that are critical to obtaining a good result)

If this implant is failing, you have the option to remove it and let the nose heal or reconstruct it immediately with rib cartilage.  There is no benefit of letting this heal and contract down, then doing the procedure later.

Good luck!  I hope I'm wrong that the implant is failing, but if it is, finding the right person will allow you to get the best results out of this process.

Best,

Dr. E

Stephen Prendiville, MD · Answer

One of the reasons that many experienced rhinoplasty Surgeons will not use ePTFE or Silastic implants in the nose is that the risk of infection is real and persists for the life of the implant.  Anectdotally, I removed an extruding silastic implant last week which was placed 30 years ago in a rhinoplasty. The bacterial content in the nasal passages coupled with the poor tolerability for motion of the implants make this a relatively high risk for aesthetic surgery

Tanveer Janjua, MD · Answer

It is possible to get a delayed infection of the nasal implant even after two years. The nostrils are a source of bacteria. Any small infection in the nostril inside can travel to the implant area. The most important thing is to control the infection with strict hand washing, cleaning the nostrils with Qtip and use antibiotic ointment and oral antibiotics. Once infection and swelling subside you will be able to tell if the swelling caused distortion of the nose and made it look crooked or if truly the implant has moved. 
Regards
Dr. Janjua

Can an implant become infected almost two years post op? (Photos)

Answers (4)