Fixing an Infection after Rhinoplasty: No Need to Wait for Revision Surgery

Fixing an Infection after Rhinoplasty:  No Need to Wait for Revision Surgery   

    As a board certified Rhinoplasty specialist , Dr.Suh was invited as speaker to Malaysian Association of Plastic, Aesthetic and Craniomaxillofacial surgeons and gave important lecture about when and with which material can the revisional secondary operation done?
    Dr Suhs new revision surgery technique minimizes the wait for unsatisfied rhinoplasty patients.
Infections after rhinoplasty surgery are generally very rare. At JW Plastic Surgery Center in Seoul,implant-related infections are reported at rate less than 0.3%. This is less than the average globally reported rate of 1-3%. 
    However, many patients who come to JW Plastic Surgery Center are looking to heal an infection from a previous rhinoplasty surgery elsewhere. 
   Some signs and symptoms of a post-surgery infection include swelling, pain, tenderness, redness, and ‘heat sensation’ in the nose.

 Local infection after Rhinoplasty

  • Local infections limited to the soft tissue of nose can be easily treated with antibiotics

   Local infections limited to the soft tissue of nose can be easily treated with antibiotics. In the case of an implant-related infection, however, the removal of implant should be considered. In this case, the infected capsule and infected surrounding tissue should be removed simultaneously, and the removal of the implant and pocket should be irrigated with a solution of antibiotics. 
   The previously accepted medical principle was that,in the case of post-surgery infections, the nose infection should be treated first, and revisional surgery for the nose shape should be performed after several months, or one year. 

  • Revision rhinoplasty: removal of the implant and infection treatment
 In some cases, however, a nasal tip deformity may occur after the removal of the implant and during infection treatment. This deformity can include tip dimpling or an upturned appearance due to capsular contracture or a thinning of the skin of the nose tip. This can happen while the patient is waiting for the secondary revisional surgery. An example is shown below.

Fig2(A) The nose before removal of implant
Fig2(B) The nose after removal of the implant

 Illustration of figures: Fig2(A) before removal of implant, Fig2(B) 3 months after removal of implant and infection control. Upturned nasal tip has worsened. Understandably, this developing deformity can cause immense stress to patients who are treating an infection and waiting for their revision surgery.     
 To prevent the worsening of nasal deformities while infection is being treated, and to relieve patients stress, Dr. Man-Koon Suh of JW Beauty Center has developed a revisional rhinoplasty surgery that can take place simultaneously to nose infection treatment.  
     There are just two conditions required for Dr Suhs simultaneous surgery to be possible: the infection should be meticulously controlled, and the material for the revisional surgery should be made from autogenous tissues, such as a dermofat graft for the nasal bridge, and use of cartilage for the nasal tip. Depending on the condition of the patients nose, Dr. Suh uses ear, septal or rib cartilage for the nasal tip. 
 Despite an infection, nose tip dimpling and an upturned tip from a capsular contracture can be corrected simultaneously alongside infection treatment. A dermofat graft can be performed for nasal bridge augmentation.

 There have been no cases of infection after Dr Suhs revolutionary, quicker revision surgery.

Fig.3(A) Contracted nose with infection
 Fig.3(B) tip lengthening(derotation graft) 

     Illustration of figures: Fig3(A) Contracted upturned nasal tip having infection, Fig3(B) Nasal tip derotation graft using ear cartilage for contracted nose correction simultaneously, alongside implant removal and infection treatment.
   This new simultaneous revision Rhinoplasty surgery technique on an infected nose  was first presented by Dr.Suh at the international aesthetic plastic surgery symposium in Seoul this year, and again at the symposium of Malaysian Association of Plastic, Aesthetic and Craniofacial Surgeons.

Lecture about when and with which material can the revisional secondary operation done?

Dr, Suh with Gregory Evans(former president of American Society of Plastic Surgery),
Yap Lok Huei (Scientific chairman of Malahysia plastic surgery society)

Dr, Suh and his cute wife with Kim K Tan
(immediate past president of Malaysian Association of Plastic Surgery) 

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