Shanghai Liu Chaofengdirect answer
If it occurs after rhinoplasty (including prosthesis, rib cartilage, ear cartilage)Persistent redness, increased pain, increased skin temperature, exudation or suppuration, should be highly vigilant against infections and go to a regular medical institution as soon as possible. early stageAntibiotic control + local debridementMainly; if the infection is difficult to control, forms an abscess, or periprosthetic infection, it is usually requiredRemoval of prosthesis/graft。After the infection is completely controlled and local tissue is stabilized, interval is generally recommended 3- 6 monthsDo two more phasesnasal repairDo not squeeze, apply heat or stop the medication without authorization
What is a rhinoplasty infection
Augmentation rhinoplasty infection refers to local bacterial colonization or invasive infection after the nose is implanted with prostheses (silicone, varicate) or autologous cartilage (costal cartilage, ear cartilage), which may involve incisions, lacunae or around the graft. No matter which material is used, there is a certain risk of infection, butDue to the complexity of the operation or the microporous structure of costal cartilage, brucosity, etc., more caution is needed in handling.。For the characteristics and selection of different materials, please refer tonasal plastic materials One article.
Infection can occur early (within a few days) after surgery, or it can be delayed months or even years later due to trauma, rhinitis, repeated irritation, and other triggers. ShanghaiDr. Liu ChaofengIn the clinic, it is emphasized that:Infection is not a small matter that "just endure it for a while". Delay may aggravate tissue damage and increase the difficulty of subsequent repairs.。
early identification signal
When the following manifestations occur, it is recommended to contact the chief surgeon or seek medical evaluation as soon as possible, and do not make your own judgments at home:
- Red:Persistent redness around the nose or incision, which expands and does not fade;
- Swelling:Swelling that should have subsided after surgery worsened, or one side was significantly swollen;
- Heat, pain:Local skin temperature increased, tenderness was obvious, and pain changed from dull pain to jumping pain and swelling pain;
- exudate/purulent:The incision has yellow or green secretions, or has peculiar smell or fluctuations;
- Whole body signals:Fever, fatigue, etc. indicate that the infection may spread.
| time | common manifestation | recommended treatment |
|---|---|---|
| Within 1 weeks after surgery | Slight redness, swelling, dull pain (normal recovery) | Nursing and observation according to doctor's advice |
| 1-2 weeks post-operatively | The redness and swelling do not recede, but become severe, exudate | Follow up as soon as possible to check for infection |
| More than 2 weeks after surgery | Suppuration, throbbing pain, fever | Seek medical attention immediately, debridement/prosthesis removal may be required |
| Months to years | Delayed redness, repeated secretions | Face-to-face evaluation and removal of graft if necessary |
Treatment and debridement
Once infection is confirmed, the principles of treatment are"Control infection, preserve structure, reduce damage"For the core:
- Antibiotic treatment:Doctors will use antibiotics empirically based on the situation, and if necessary, do secretion culture + drug sensitivity, and use targeted drugs.You cannot purchase medicines yourself or stop medicines without authorization。
- Local debridement:Rinse, drain, and change dressing the exudate and pus areas of the incision to keep the drainage smooth.
- Indication for removal:If the infection remains uncontrollable after antibiotic + debridement, an abscess forms, or an obvious infection around the prosthesis/cartilage, it is usually requiredRemove the prosthesis or graft, and perform secondary repair after the infection is completely controlled.
Whether and when to remove it needs to be comprehensively judged by the doctor based on physical signs, imaging and laboratory tests. Dr. Liu Chaofeng reminded:Prosthesis removal is not a "failed operation" but a necessary step to control infection and protect nasal tissue。
Prosthesis removal and secondary repair
After the prosthesis or graft is removed, the nose will undergo a process of inflammation subside and tissue remodeling. Regarding the choice of repair timing, please refer tonasal repairThe overall plan is planned together.
| stage | Target | approximate time |
|---|---|---|
| acute phase | Control infection, remove graft, drain | From the day of treatment |
| stable period | The redness subsided, the wound healed, and there was no secretions | 1-3 months after removal |
| secondary repair | Nasal morphological reconstruction and functional assessment | General interval 3-6 months |
The interval between secondary repairs is not as short as possible. Tissue needs enough time to restore blood supply and stability, and premature surgery may increase the risk of re-infection and malshape. The specific interval will be determined by the doctor after face-to-face consultation. If you have had rhinoplasty elsewhere and want to understand the difference between simple rhinoplasty and comprehensive rhinoplasty, please readNasal synthesis and simple rhinoplasty。
home FAQ
Q: Is there a slight redness and swelling after rhinoplasty?
A: Not necessarily. Minor redness and bruises in the early stages of surgery are mostly a normal recovery process and usually reduce day by day. If redness and swelling continue to increase, accompanied by pain, jumping pain or exudation, you need to be alert to infection and seek medical advice promptly.
Q: Can I just take anti-inflammatory drugs without taking out the prosthesis if I am infected?
A: For early, limited, and mild infections, doctors may try antibiotics + debridement control first. However, whether the prosthesis needs to be removed depends on the scope and control of the infection. It must be evaluated by the doctor and cannot be decided by himself.
Q: Will the nose collapse after the prosthesis is removed?
A: The height of the dorsal nose may decrease after removal compared with before surgery, which is a common temporary change during infection control. After the infection is stabilized, the shape can be reconstructed through secondary nasal repair. The specific plan requires face-to-face diagnosis design.
Q: How long can nasal repair be performed after infection is controlled?
A: It is generally recommended that the interval be 3 - 6 months after the infection is fully controlled and the local tissue is stabilized. The specific time varies depending on the individual's recovery, withShanghai Liu ChaofengThe doctor's face-to-face evaluation shall prevail.
Q：Costal cartilage rhinoplastyIs it more difficult to deal with an infection?
A: Costal cartilage is autologous tissue, but rib removal and carving add to the operation process. Once infection is also infected, standardized debridement is also required, and the recipient cartilage is removed if necessary. The principle of treatment is similar to that of prosthetic infections, emphasizing early treatment.
Q: Will there be a fever if you are infected with rhinoplasty?
A: A more obvious or spread infection may be accompanied by systemic symptoms such as fever and fatigue. This is a sign that the infection is worsening. You should seek medical attention immediately without delay.
This article is popular science content and does not constitute medical advice. Any nasal infection or repair plan must be formulated in a regular medical institution and after face-to-face evaluation by a qualified doctor. If individual results differ, please refer to the doctor's face-to-face evaluation opinion.
This article was compiled and published by Dr. Liu Chaofeng.
