Recurrent scabs with green discharge nearly three years after my septorhinoplasty. What could be the cause of this? (Photos)

Question

I underwent a septorhinoplasty in January 2022, everything went well and I thought I had healed fine. Fast forward to December 2023 and the inside of one of my nostrils was getting itchy, which then developed into scabs and leaking a green and then clear discharge. My nose was also noticeably swollen. I did realise that the scabs seemed to be along where my incisions were. It did eventually go away within about 10 days. Fast forward to now (Oct/Nov 2025) and the exact same thing is happening again. I did get in contact with my surgeon the first time it happened and he recommended a cream to put on it (that wasn’t available in the UK). Can anyone advise on what exactly it could be and should I be concerned about it?

Eyup Bozkurt, MD · Answer

After cleaning the area and using a topical cream, if this keeps recurring, the underlying cause could be a non-dissolvable suture in that location. Removing that suture would typically resolve the problem completely.

Eric M. Joseph, MD · Answer

Some surgeons utilize permanent suture material to alter the appearance of underlying nasal tip cartilage, and you could have a permanent suture, underneath the skin, that is leading to recurrent inflammation. If that is the case, and this could be confirmed by your surgeon, removal of the offensive suture could be curative. The other possibility is herpes nasalis. This is essentially a cold sore of the nose, and it could represent a viral infection. This may be the case if the area started off with a blister that ultimately ruptured and made a scab. If the photo represents a viral infection, it will run its course, and the next time it happens, should it happen again, if you were to take an antiviral medication like valcyclovir, it may decrease the severity and duration of the outbreak. I hope this is helpful for you. Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs and description, there could be a non-dissolving suture deep to these tissue which could be the cause. This may need to be removed. . I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Ronald J. Edelson, MD · Answer

It looks like you have an area of exposed cartilage that may be causing your recurrent issues.  The cartilage could be trimmed back and that has a good chance of fixing the problem. Also it may be a cartilage graft that is infected and removing the graft might help

Jeffrey H. Spiegel, MD · Answer

Could be unrelated, could be that there is a permanent suture that was placed in the area. Find out what kind of stitches were used in your surgery.

Rafael Ramos Vecchio, MD · Answer

Hi!A better exam and more questions about the behavior of this is needed. Best case scenario you have been rejecting the suture material they could have used to reduce the width of the base of the columella and creating granulomas that end up draining to the skin. Worst case scenario, you have a chronic infection of the cartilages they manipulated during your surgery. This can only be treated by a combination of antibiotics and a surgical procedure where they remove the infected cartilage and wash profusely. Getting cultures from the tissues and drainage is also important to find the right medication to treat it with. 
You should visit a rhinoplasty surgeon in person to get a better assessment and treatment plan.
Hope this helps!
Rafael Ramos Vecchio MDPlastic and Reconstructive SurgeonCoral Gables, FL

Thomas Spalla, MD · Answer

Given the recurrent nature of this issue and that it continues to occur at the exact same spot, I am suspicious that a foreign body (suture, implant) is present at that site which continues to get reinfected through a small communication in the overlying skin.

Culture-directed antibiotics are warranted.

Get the operative report reviewed by your surgeon, or other board-certified rhinoplasty-experienced surgeon. An exploration of that site is likely warranted at this point.

Recurrent scabs with green discharge nearly three years after my septorhinoplasty. What could be the cause of this? (Photos)

Answers (7)

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