Surface Infection One Year After Rhinoplasty

This appears to be an infection in the cartilage graft and overlying skin. After 1 year, this probably started as an area of breakdown in the skin over the graft, perhaps from pressure, irritation, or thin skin that just allowed bacteria in. Infection starting in the graft or sutures would have presented itself earlier, causing the skin breakdown rather than the other way around. At any rate, now things look the same--skin breakdown and infected cartilage graft beneath with persistent drainage. This will not get better on its own!

You should see your surgeon immediately for culture and antibiotic therapy that can be adjusted if the cultures require. You may lose a portion of your graft, but after 1 year there should be enough stability in the reconstructed nose to maintain appearance. A small touch-up procedure could be performed once all is healed if necessary for optimal improvement.

This is an infection until proven otherwise; please call your surgeon today!

I read your concern and reviewed your photo. Recurrent infection with purulent drainage at your left columella is likely originating from a permanent suture that might have been used to anchor your ear-cartilage graft in place. If that's the case, you would benefit from seeing your surgeon for evaluation and possible suture removal which could resolve the situation. Also, your surgeon could obtain a specimen for culture and consider a trial of oral antibiotics.

Ask your surgeon if any foreign-body materials were used to reconstruct your nose.

I hope this is helpful for you.

This is a suture abscess. See your surgeon instead of doing self drainage. The stitch can be removed in the office with local anesthesia and prevent recurrence of the problem.

From your description I would very much suspect a suture has become infected.  In all likelihood this is not the result of anything you or your surgeon did wrong, it can just happen.  While the condition may resolve with aggressive antibiotic treatment, it is almost certainly going to recur at a later date.  In my opinion, the only course is to open up the area, find the offending suture and remove it.  The problem may be directly under the pimple, or it may be tracking under the skin from someplace nearby.  Usually, removal of the suture is possible without affecting the overall appearance of the nose and without an outright rhinoplasty revision.  It is certainly possible the problem in your nose is more widespread, but I suspect an isolated suture, removal of which should cure the problem.

The small pimple like area of infection you describe suggests a suture that has been retained such as a permanent or nondissolving suture t hold cartilage grafts in place. Keep the area clean and keep hands away. Let your surgeon see you to get the situation under control.
Best of luck,
peterejohnsonmd