Revision on a Discolored Nose?

Question

Hello, I'm about six months out from a revision rhinoplasty in which I believe my skin was thinned. I am a fair skinned caucasian so I don't think that if there was skin thinning it was a good idea. Now my tip is a reddish/ pink and the skin looks mottled. My nose also doesn't look good and I can't breath. I need another revision possibly requiring rib, is my skin an indication that it may necrose if I have another surgery? Will it thicken up or strengthen in the future so I can have surgery? Thanks

Jamil Ahmad, MD · Answer

Nasal skin discoloration can be an ominous sign after rhinoplasty. Persistent 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. It sounds like you have had previous nasal surgery and your skin is now even thinner. With the skin discoloration, it is best to wait for the discoloration to settle and the skin and soft tissues to recover prior to considering any further surgery. When revision rhinoplasty is performed too soon, this tenuous skin may not heal well and result in skin necrosis. It is hard to say just how long you have to wait, but typically a year or more is needed to allow the tissues to heal. Additionally, after most rhinoplasty surgeries, it is best to wait at least a year for the swelling to resolve and the scar tissue to start to soften - after revision rhinoplasty it may be best to wait even longer than 1 year. In the case of thin skin, the skin is unlikely to thicken with further surgeries.In the interim, injection of soft tissue fillers may be an option to augment areas of the nose or fill in depressions. However, even with injectables, the circulation of the nasal skin must be respected. There is a limit to how much product can be injected and how tolerant the nasal skin will be-tissue necrosis can also occur after soft tissue filler injections to the nose. You should consider consulting with a board certified plastic surgeon that commonly performs revision rhinoplasty as well as injectables into the nose to see what would be best for you.

Kimberly Lee, MD · Answer

An in-person consultation is warranted to thoroughly examine the inside and outside of your nose to determine how best to address your areas of concern. Evaluating your tip will also give a better indication of the situation.  Please consult with a board certified specialist who can assist you in achieving the results you seek.

Francis R. Palmer, III, MD (retired) · Answer

Nasal skin that's red-pink or shades of purple indicate decreased blood supply.  Having further Rhinoplasty Surgery, in that scenario, risks severe damage to that skin and should be avoided.

David Alessi, MD - Account Suspended · Answer

A detailed answer can't be given without an in-person exam.  Generally, the are a few comments.  Redness in the tip after surgery usually gets better over time.  If steroids were injected, it can take up to a year.  Lasers can help with persistent redness.  If the skin was overly thinned, it may build up thickness over several months.  This issue is elevating the skin surgically to place an implant can be difficult.  Make sure you seek out a board-certified Facial Plastic Surgeon well versed in revision rhinoplasties.-  Best wishes

Revision on a Discolored Nose?

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Answer: Revision rhinoplasty

Answer: Revision rhinoplasty

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Revision on a Discolored Nose?

Answers (4)

Answer: Revision rhinoplasty

Answer: Revision rhinoplasty

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Everything you need to know about Revision Rhinoplasty

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