Q: Dr. Eppley, I had rhinoplasty done five years ago and developed a recurring abscess on top of my nose several years later. It was needled and cultures which turned out negative. I noticed a suture coming out but swelling with pus still builds up every week . I have been on Augmentin a few times but with no relief. What should I do? Is surgery needed?
A: Your descriptive history suggests that there is a foreign body in the nose that needs to be removed. Whether this is from a permanent suture or from an implant I can not say since I do not know what was specifically done during your procedure. If there was an implant placed in the dorsum of the nose then there would be no question about the source of the infection
But with recurrent swelling years after the original procedure and failure to resolve completely with antibiotics suggests that open exploration is needed to determine the source. Infection after rhinoplasty surgery are fairly rare particularly when autologous cartilage grafts are used. But sutures used inside the nose in rhinoplasty can be a known source of tissue irritation particularly if there are of the non-resorbable composition.
Dr. Barry Eppley