Is This Synechium Scar Tissue After Revision? Does It Cause Swelling? (photo)

Question

1st surgery was in Oct 2008. I had a silicone L-shaped implant inserted. I first noticed this weird nostril-blocking fleshy-thing sometime after the surgery. I ignored it because I thought it was inside of my nose anyways and no one is going to see it unless they look up my nose. Revision in Nov 2011. Implant replaced with ear cartilage. The fleshy nostril-blocking thing on my right nostril is still there. I found out it was called a synechium. Is this scar tissue? Does it cause swelling? Thx.

Kristina Zakhary, MD, MSc, FRCSC · Answer

This band of scar tissue is indeed a Synichia and it can occur after any rhinoplasty or revision rhinoplasty surgery. If it is causing you to have nasal obstruction (decreased breathing from your nose), it can be treated. If it is not causing any symptoms, it is advisable to not treat it, since all surgical treatments have risks associated with them, and you must decide if the benefits outweigh the risks. I hope this was helpful to you.

Stephen Prendiville, MD · Answer

Your picture appears to show scar tissue in the nasal vestibule, probably extending into the internal nasal valve. This is one of the most difficult complication to correct after Rhinoplasty. However, release of the scar tissue followed by application of mitomycin might be helpful.

Mohsen Tavoussi, MD, DO · Answer

This type of scar tissues can and do cause obstructive symptom and can be corrected with incision  ( laser vaporization is best ) and silicone sheet splint between cut areas for several days.

Michael L. Schwartz, MD · Answer

It is a web which is scar tissue. Unless it is causing you breathing problems it requires no treatment.

Peter A. Aldea, MD · Answer

The"fleshy nostril-blocking thing" IS scar tissue bridging across the apex of the nose, in this case, near the nasal valve, a very important part of the nasal airway. These are quite challenging to get rid off and are best avoided.

Richard W. Fleming, MD (retired) · Answer

This is a band of scar tissue called a "synechia" which can be reduced or eliminated surgically. It probably does obstruct nasal air flow.

Francis R. Palmer, III, MD (retired) · Answer

This appears to be a web along the top portion of the incision used in a Closed Rhinoplasty. Rhinoplasty Surgeons sometimes don't close that section of the incision but I always do in order to prevent just such an occurrence.

Is This Synechium Scar Tissue After Revision? Does It Cause Swelling? (photo)

Answers (7)