Rib graft extruded. Is this an infection?

Question

Hi I am currently 4 weeks post op rhinoplasty and am noticing an edge of the autologous rib spreader graft extruding out inside my left nostril. There is some slight discomfort in the tip area as well. I believe I have an infection. Does the entire spreader need to be removed, or just the extruded section? There are other autologous grafts in my nose as well; do these need to be removed? Lastly what antibiotic is strong enough to temporarily treat this type of problem? Thank you for your help.

Oakley Smith, MD, FRCSC · Answer

Its unusual for a post operative infection to start a month after surgery. It is most common around 5 days to a week. The diagnosis needs to be confirmed, so your surgeon must examine the area. Small cartilage grafts (like spreader and tip grafts) can often be successfully treated with antibiotics and they don't need to be removed. Unfortunately rib grafts are usually larger and all too frequently 'melt away' from the infection. Both clindamycin and keflex are good choices.

Richard J. Brown, MD · Answer

This is one of those situations that is so hard for all of us to really advise you on. A physical exam is very important so please go back to your surgeon for an exam. If the cartilage is exposed it might be able to be trimmed and the wound closed. The longer you wait the worse off it can become. You might find if you have gross infection that the rib graft will dissolve away over time. It could also be nothing more than a undissolved suture from the incision or from surgery in general. This is why it is so important for you to see someone sooner than later. Skin bacteria are most common to cause infection so Keflex or Clindamycin should be adequate for soft tissue. There are some others with better cartilage penetration but really this sounds like it could be soft tissue

Robert Mounsey, MD · Answer

The graft may be infected. Unfortunately this can occur.  The graft may need to be removed, or trimmed.  The area must be examined carefully, if the graft can be salvaged and the infection controlled this is a good option.  The other grafts in the nose are most likely fine and can be spared. Removal of too many grafts will change the shape and support of your nose.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

Sounds like your rib spreader graft got infected and is extruding or vice versa. Either way the graft should be removed. Your surgeon will know the best choice of antibiotics for you, but the real treatment is removal of the implant.

Best,

Dr.S.

Rib graft extruded. Is this an infection?

Answers (4)

Answer: Rib Graft Infection

Answer: Rib Graft Infection

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Rib graft extruded. Is this an infection?

Answers (4)

Answer: Rib Graft Infection

Answer: Rib Graft Infection

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Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.