Permanent Suture and Metal Plates in my Nose Causing Irritation?

Question

In order to safeguard the stability of my nose, a permanent suture and two tiny metal plates were used to hold my nasal septum in place. This procedure took place during my fourth and latest rhinoplasty which is now 5 years ago, after which I have had recurring nasal swelling problems. I asked my question as a way for me to find out if I can eliminate "the permanent suture + metal plates" from the list of "suspects" behind my nasal dilemma. Thanks ever so much for your informed help!!

Toby Mayer, MD · Answer

Metal plates are usually removed after a few weeks. The permanent sutured would only cause a "pimple" if it was coming out. You should consult with a Revision Rhinoplasty specialist, especially since you have had so many surgeries. Many surgeons may say they are, but I'm sure you have found out the hard way that they are not.

Paul S. Nassif, MD · Answer

It may be a good idea to get a CT scan of your nose and facial bones.  This will be the least invasive way to get an idea of what may be the etiology of your nasal swelling and irritation.

Oakley Smith, MD, FRCSC · Answer

Permanent sutures are common with Rhinoplasty. Metal plates are rare. It could be a metal screw but this would be out under the skin of your cheek. Ask you last surgeon or get an xray. It most likely just a suture which can be removed if needed.

Stephen Weber MD, FACS · Answer

Dear Nordic - I would echo the sentiment of my colleagues. However, my suspicion is that you have a Mitek anchor or metal screw in your face with a permanent suture passing into the nose from the cheek to hold the nasal airway open. These are used relatively infrequently and infection around the suture or anchor is not uncommon. Best of luck.Stephen Weber MD, FACS

Kevin Brenner, MD, FACS · Answer

It is unusual, but not unheard of, for permanent sutures and metal plates to be placed during rhinoplasty. I suspect that you may have a serious issue with your nose if metal plates were required. If you are continuing to have problems with the plates, it may mean that you have a subclinical infection occurring. You should go back to your plastic surgeon for an evaluation; you may need some sort of imaging procedure such as a CT-scan of your nose and facial bones. If the plates are indeed infected, they should be removed and you should be reconstructed with your own tissues. This may require rib grafting.

Raffy Karamanoukian, MD, FACS · Answer

I see patients with foreign bodies in their nose after secondary or tertiary rhinoplasty. These foreign bodies can often cause a reaction and should be evaluated closely to see if they are potentially causing more harm in the long term. I perform rib grafts on the nose for these advanced cases.

Permanent Suture and Metal Plates in my Nose Causing Irritation?

Answers (11)