Understanding the Risks and Management of Rhinoplasty Side Effects

Card 1. Side effects after rhinoplasty

In general, the result after plastic surgery settles down in about six months; however, the stable period for rhinoplasty with implants is hard to be estimated even years past. Various side effects may occur, including inflammation due to decreased immunity, the implant migration from external shock, the implant being seen from the outside due to the thin skin, and implant protrusion through the skin. The worst side effect among these is the implant protrusion. See what Dr. Seong Yong-hae at GNG Hospital said about this symptom in detail.

Card 2. A reported case of side effects after having rhinoplasty

Ms. S (34) had a rhinoplasty with silicon and ear cartilage at the “A” plastic surgery clinic in Gangnam 12 years ago. At first, she was satisfied with the pretty and natural shape. Then she began to smell a musty odor from the nose several months ago. When she visited a clinic specialized in nose revision, she found out that the “Medpor”—the implant that supports the columella—had protruded through the mucosa, and inflammation occurred from it, requiring revision. She had no idea that such an artificial implant, not cartilage, was inside her nose. Even worse, the clinic in which the surgery was performed, does not exist anymore.

Card 3. The process of implant protrusion after rhinoplasty

Implants mostly protrude through the nasal skin or the inner mucosa. Although tissue damage or contracture from inflammation may be the cause, there are many cases of the skin becoming thinner as the skin tension increases due to the implant. Once the skin is perforated, numerous bacteria enter the wound, causing inflammation for sure.

Card 4. The cause of implant protrusion through the skin on the nose tip ①

This occurs as the implant presses the skin and gradually becomes thinner—commonly seen in those with L-shaped silicone implants in the past. Also, as the implant moves, it slowly descends to the nasal tip due to gravity and presses it, piercing the skin at the end. This happens in closed-rhinoplasty, in which fixing the implant is difficult, or in an open rhinoplasty when the implant moved due to an external shock.

Card 5. The cause of implant protrusion through the skin on the nose tip ②

There are possible causes of the protrusion: ▲the destruction of mucosa due to inflammation ▲insertion of nonabsorbable implant like Medpor to support the columella ▲constant stimulation of the inner nasal mucosa by the implant movement ▲excessive elevation of the nasal tip.

Card 6. Solutions to implant protrusion

Prioritize removing the implant as soon as possible and cleansing out enough to minimize inflammation. Once the skin is perforated, inflammation increases exponentially, and the skin drastically melts down—becoming untreatable even with antibiotics. Revision rhinoplasty should be considered after waiting for the tissues to become stable.

Card 7. Take caring for fast recovery after the implant removal surgery

First, manage your condition and have treat inflammation with therapies of hyperbaric oxygen, stem cell, or PRP(autologous platelet-rich plasma). Although removal of the implant and cartilage is successfully done, contracture and shape deformity are inevitable. At that, stem cell therapy, which has differentiation ability, is effective for fast recovery and prevents contracture and shape deformity.

Card 8. What to Check for Revision Rhinoplasty

Despite the full recovery of the tissues for revision, the goal of surgery should be reconstruction rather than impractical aesthetic surgery if you have experienced skin perforation, contracture, and shape deformity. In this case, it is recommended to use materials such as autologous dermis or costal cartilage. Autologous tissues have a low chance of inflammation and do not penetrate the skin or mucous even if the skin is pressured or pressed down.

Card 9. Advice: Dr. Seong Yong-hae at GNG Hospital, advisory committee member of K-Health

“Side effects like implant protrusion may occur anytime after a nose job. So constantly checking for abnormal symptoms is recommended. If the implant protruded, remove it as soon as possible and consider a revision after waiting for the tissues to become stable enough.

Card 10. TIP. How to check what material and method was used for the surgery

Patients should remember what exact type of surgery was performed and keep a copy of medical records. Although general medical consumers have trouble with fully understanding the surgical materials and techniques, being aware of them helps to determine the causes and plan treatments if adverse events occur in the future. According to the medical law, clinics are required to keep the surgical records and medical charts for 10 years and are not allowed to refuse issuing copies without valid reasons.

•This post is created from the article published on November 27. 

https://www.k-health.com/news/articleView.html?idxno=51174

•Medical advice: Dr. Seong Yong-hae, appointed as a K-Health’s advisory committee member on cosmetic surgery

Reporter Ji-Sun Sim