Recurring infection post rhinoplasty. What could it be? (Photo)

I have seen this once before.  A patient had a rhinoplasty where a braided permanent suture was used.  We had to widely open her nose, remove every single suture, flush it with antibiotic solution and then close.  No new infections and her nose looks awesome.  Do you know what kind of suture was used.  A culture of any of the abscess fluid would also help but if there is still foreign material (which I suspect is the case) in your nose, you have to get 100% of it out. The infection will never clear until that is the case, even if you know the species of bacteria you have with the culture.     

Hi,Recalcitrant infections are sometimes caused by atypical mycobacterium. It is likely necessary to biopsy the area and check for this particular organism. Best,

Hello,
This are need to be biopsied before that should be swabbed. It would be a better after your PS to consult a dermatologist, as you had the operation 2 years ago the  nose already took the final result.
Kindly Regards,

This seems a very difficult problem for you.  The area should be swabbed when it flares up. When it is calm it should be biopsied.  The opinion of a dermatologist would be very helpful.  If it is due to a permanent suture then probing the wound directly from the outside and exploring it through the skin under magnification should have a good chance of finding it in the base of the wound.

What you are going through sounds like a nightmare!  It's is important to realize your surgeon is not at fault here and in my experience, I believe you have an extremely slow-growing anaerobic bacteria - likely Clostridium or Fusobacterium.  These types of bacteria are found in our tap water, but can infect the tissues.  They won't grow on normal aerobic bacterial culture, but require anaerobic culture that grows over many weeks.  Thus, you need to see an infectious disease specialist and culture this when you have purulence and then be placed on the appropriate antibiotics, usually for weeks.  Best of luck!

Hi and welcome to our forum!If a buried permanent suture becomes infected, it must be removed to eliminate recurring infections. If there is non-viable or vascular insufficient tissue, it must be removed. Has there been a culture of the purulent drainage?If the infection is still there after 2 years, there must be an offending agent which must be discovered and removed. A third reexploration under general anesthesia is required. Best wishes...

The area needs to be biopsied.   This infection could be totally unrelated to your Rhinoplasty.  It is not uncommon to have skin cancer in the nose.  Since your surgeon cannot identify the problem, it may be time to see a Dermatologist.