Treatment Provider

Lucian Ion, FRCS
Specialist Registered Plastic Surgeon
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Photo collage of over 7.5 year update post rib rhinoplasty

January 2024 update, over 7.5 years post rib rhinoplasty with Lucian Ion. Excellent longterm outcome. In May it will be 8 years postop. I have had no issues since the prolene sutures were replaced with pds sutures.

Over 7 years post rib rhinoplasty and all is still super.

I would highly recommend Lucian Ion for rib rhinoplasty. Remember to ask for pds sutures and not prolene sutures and take postop doxycycline antibiotics. I smile when I recall years ago how he felt he could not guarantee the stability of the rib rhino with pds sutures, yet here I am approaching 8 years in May with his rib rhinoplasty still intact! I assume scar tissue has now formed and replaced the absorbable sutures.

Nasal tip abscess may have been due to prolene allergy.

I have watched a recent episode of botched with a lady diagnosed with a prolene allergy resulting in a nasal tip abscess! I found an article on such an allergy in the JLO. https://www.cambridge.org/core/journals/journal-of-laryngology-and-otology/article/nasal-tip-abscess-due-to-adverse-skin-reaction-to-prolene-an-unusual-long-term-complication-of-rhinoplasty/82EA6FC06E1A2C87B59DCE1AF23C4190#:~: textAllergic%20reactions%20to%20Prolene%20are,nasal%20tip%20swelling%20and%20redness. As I suffer from eczema and contact dermatitis to synthetic material, I may well have had an allergy to the blue prolene sutures buried in my nose that then caused the abscess.

Provider Review

Specialist Registered Plastic Surgeon
Aveling House, 1B Upper Wimpole St., London,
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Updated June 22, 2021. My star ratings for Mr Ion is 5 stars based on a 5 year outcome after his first open rhino, handling of the postop abscess, taking me back to theatre, as I love my nose and have come to terms with the asymmetric nostrils. I will not pay for alarplasty or any further revision. The asymmetric nostrils are less noticeable at 5 years unless one looks up my nose so I have given back the 5th star. When confronted with a postop rhinoplasty abscess at 2.5 weeks, Mr Ion saw me same day for I&D, treated with weeks of antibiotics, and subsequently took the time to see me on a Sunday to reexamine and explained why he had used permanent sutures and at 2 months postop took me back to theatre for exploration, restructuring the rib cartilage and replacing all permanent sutures with the longest lasting absorbable suture, PDS. He listened and understood my anxiety over possible future infections with permanent sutures and agreed to take me back to replace with PDS, which dissolves in approximately 6 months. He did not make me suffer and wait a year for revision with a collapsed nose tip and anxiety over the permanent sutures. He did not charge for his fee or the anaesthetist's saying he would cover this himself and I paid the hospital overnight stay fee. The next morning after the operation, he sat down and explained that the infection had not taken away any rib cartilage but instead had caused the base cartilage graft to move which then dropped my tip. He repositioned the base cartilage and the projection is improved or as he put it he has left me with an even better nose! The clinical dilemma was will 6 months with PDS before it dissolves be enough time for my collagen to grow to hold the grafts in place. Fingers crossed the stability remains after 6 months! And now at 5 years plus can say yes it held!!! I was hopeful as why else would some surgeons use dissolvable sutures in the nose and some use permanent. There does not seem to be a perfect answer, which explains the ongoing debate among plastic surgeons over suture material inside the nose. Mr Ion initially got 4 stars for aesthetic appearance in rhinoplasty (as my nostrils are asymmetric when before I had perfect symmetrical nostrils), however he is attentive and takes time to listen and address concerns of the patient , provides postop care and follow up and a willingness to see it through the end with the patient. Now at 5 years post, he gets 5/5 as the pds dissolvable sutures have held the rib grafts in place with scar formation. This is a perfect outcome for a patient with allergic contact dermatitis so can not tolerate permanent sutures and the minor alar asymmetry is a small price to pay for the revision to replace the sutures and rebuild the tip. I have used a pseudonym on this forum.