Explanation for Pain and Drainage Years After Septoplasty and Rhinoplasty?

Question

Is it possible that almost 2 year post septo/rhinoplasty a strut graft or the upper lateral cartilage can shift into the nostril and cause external pinching to the left nostril and some internal nasal obstruction?

	Also could I have brought this on myself if I was carefully pushing the tip of my nose to the right on occasion because the tip of my nose was shifting to the left (the original position prior to the surgery)?

	I have alar strut and rim grafts in the nose using septal cartilage. They also did a tongue and groove technique on the tip for the overprojection. I had dorsal hump removal and osteotomies done.

	And now almost 2 years later I have neuralgia, pain, the tip is hard and feels wrong, scar tissue on the top left of the osteotomy site, and can barely touch my nose, clear drainage coming from my nose, and my nose hardening and internal mucous membrane swelling due to environmental smells. Why? Will it ever get better?

Pat Pazmino, MD, FACS · Answer

In your case, it sounds that you may have a small infection that continues to flare up intermittently. Your best bet is to return to the rhinoplasty surgeon that performed this procedure and let him know your concerns, they may assess the wound and determine what is causing the production of this drainage and pain. It is possible that a foreign body may be irritating the deep tissues and causing this drainage. Although less common, a cartilage graft may be responsible. Your rhinoplasty surgeon will review your symptoms along with your operative note and description of the procedure to help determine the cause.

Steven Wallach, MD · Answer

I am sorry you are having all these problems. You may have an exposed graft that is causing you problems that may require removal.  You should see a rhinoplasty a specialist.

Philip Young, MD · Answer

The clear drainage is not likely indicative of an infection but the foul smell is an indication. As long as they didn't use foreign material for the grafting, your chances are better that this is not an infection.
I would definitely have someone look at this to make sure it is not getting infected. The upper lateral graft can cause impingement of your internal nasal airway if it wasn't done in the right way. Warping can happen to anybody and any surgeon though and this is a risk with ear, or rib grafts. Septal cartilage is less likely. There is a possibility of a foreign body as well that was or wasn't meant to be in there such as suture material, guaze material etc.
In terms of bringing it on yourself, I wouldn't suggest manipulating the nose in the way that you described unless directed by your doctor. There are delicate sutures in there that manual pressure, depending on how forceful, can dislodge and create issues such as what you are describing.
I hope this helps!

Francisco Canales, MD · Answer

Hello,
I would suggest having a consultation from a board-certified plastic surgeon who specializes in secondary rhinoplasty. There are a handful of plastic surgeons and facial plastic surgeons who make rhinoplasty their careers. They are used to dealing with difficult problems like yours and it would be worth traveling to see that particular surgeon. I know of at least 2 such surgeons in California and I believe there are some just like that in Dallas as well as the Midwest. 
Your own doctor could recommend a physician who specializes in secondary rhinoplasty. We have sent a few patients with very difficult problems to one surgeon in Southern California with excellent results.
Do not despair. You must seek the right help and be willing to travel to find the right surgeon. If you don't have luck with a referral from your own doctor, The American Society for Aesthetic Plastic Surgery would be a good resource to start with.

Richard W. Fleming, MD (retired) · Answer

It is possible to see subtle changes many years after rhinoplasty surgery. However, this rarely results in better function or appearance. Little will be gained by waiting. You do have problems with pain and drainage which should  be evaluated in the neaqr future.

Explanation for Pain and Drainage Years After Septoplasty and Rhinoplasty?

Answers (5)

Answer: There are doctors who specialize in secondary rhinoplasty

Answer: There are doctors who specialize in secondary rhinoplasty

Answer: Post Rhinoplasty Problems

Answer: Post Rhinoplasty Problems

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Everything you need to know about Septoplasty

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Explanation for Pain and Drainage Years After Septoplasty and Rhinoplasty?

Answers (5)

Answer: There are doctors who specialize in secondary rhinoplasty

Answer: There are doctors who specialize in secondary rhinoplasty

Answer: Post Rhinoplasty Problems

Answer: Post Rhinoplasty Problems

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Recommended reading

Everything you need to know about Septoplasty

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