What is this redness after revision rhinoplasty?

Question

I had a revision rhinoplasty 6 months ago. And my results are favorable expect for the discoloration of the lower 2/3 of my nose. It is constantly a bit more red than the upper part, making it look like my nose is made up of 2 different noses. Is this still swelling? I do not have any infection or discomfort.

Richard H. Tholen, MD, FACS · Answer

At six months after revision rhinoplasty, most of the healing, softening, and swelling resolution has occurred, but you may still see subtle changes for up to a year. Residual redness in the lower 2/3 of the nasal skin can be related to the surgical changes in the skin's circulation--by now this is probably relatively stable and unlikely to improve dramatically, even with further passage of time. Or, you may also have had early or undiagnosed Acne Rosacea that has either flared following your surgery, or simply become more visible at this time totally coincidental to your nasal surgery. In either case, consultation with a Dermatologist may provide topical or oral medications that can provide improvements in about half of cases. I'd start here.

	If this is unsuccessful, then IPL or pulsed dye laser treatment by a qualified and experienced laser surgeon can dramatically improve the redness (due to dilation of the superficial capillaries in the skin), often with just one or two treatments, and regardless of the cause! This is your second step! Good luck!

Jamil Ahmad, MD · Answer

Persistent nasal skin discoloration can occur after rhinoplasty. Reddish-purple discoloration as well as slow capillary refill (blanching of the skin with pressure followed by a very slow return of the pink color after the pressure has been removed) that alters with temperature can signify altered and compromised circulation in the nasal skin. Over time, the discoloration should slowly improve and in many instances will eventually return to normal. It is hard to say just how long it will take but typically a year or more is needed to allow the tissues to heal.

Sam Naficy, MD, FACS · Answer

If the vascular changes are still present at one year you may wish to try IPL or YAG laser treatments - these will reduce the vascularity and redness of the skin

Eric M. Joseph, MD · Answer

I read your concern. Persistent, non-tender redness of your nasal skin after revision rhinoplasty surgery will slowly resolve. I have seen this in a small number of patients following rhinoplasty surgery, and it may represent an exacerbation of rosacea.

	If your surgeon is unable to help you, you could consult a reputable dermatologist for advice. In my practice, 3 or 4 IPL PhotoFacial treatments have been helpful in reducing nasal redness.

	I hope this is helpful for you.

Otto Joseph Placik, MD · Answer

If you do not have an infection the redness is most likey due to hyperemia from postoperative vascular engorgement unless you ahve some other condition such as rhinophyma.

Thomas A. Lamperti, MD · Answer

The redness you note could be from persistent swelling which would still be present 6 months after surgery.

	You should check with your surgeon, though, to make sure it is normal for your circumstances.

Steven Wallach, MD · Answer

This can be  a post-surgical inflammatory reaction that may take up to a year to resolve.   This can also be from swelling as well.  Sometimes lasers treatment can help.

Michel Siegel, MD - Account Suspended · Answer

Dear Cleveland:

	Because the skin has been lifted and stretched after surgery, in your case twice, it is not uncommon for that skin to sprout new blood vessels as healing is taking place. The redness should improve in another six months or so, but sometimes an IPL laser treatment is required to bring down all the redness.

	Dr Siegel

What is this redness after revision rhinoplasty?

Answers (8)

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