Skin Irregularities on The Nose After Nose Job

Collapse, Irregularity, Color Changes and Pitting on Nose Skin After Rhinoplasty

Skin Irregularities After Rhinoplasty, Color Changes on The Skin After Nose Job, Pitting on Nose Skin, Collapse on Nose Skin After NOse Aesthetic Surgery

During the rhinoplasty operation, various operations are performed on the skin and subcutaneous tissue, cartilage structure and bones. Depending on the tissue dissection performed during the rhinoplasty operation, the skin incisions made, the suture materials used close to the skin, the use of electrocautery and the drugs used on the skin, the following problems may occur on the skin after the rhinoplasty operation:

- irregularity
- color changes, darkening
- pitting
- crash
- flowing foci of inflammation

These skin complications, which I have shared with you here, are usually seen after revision rhinoplasty operations and the probability of being seen increases after repetitive surgical procedures.

Skin irregularities after rhinoplasty

Although it is more likely to be seen especially after revision rhinoplasty; during rhinoplasty operations, skin problems may occur due to the following skin-related conditions:

Skin pitting, collapse

The photo above belongs to a patient who had undergone rhinoplasty twice in a different clinic, and as seen there, inward dimpling of the nasal skin may occur due to the following reasons:

- excess subcutaneous tissue excision for the purpose of thinning the nasal skin
- very thin removal while dissecting the nasal skin
- circulatory problems and healing problems in the nasal skin (may be due to repeated surgery and skin dissections; may be due to excessive radiofrequency application)
- when there are non-absorbable sutures under the skin, skin collapse and color changes may occur in the early period and inflammatory discharges may begin to appear from the skin in the late period (you can check the video below)

Darkening color changes on the skin of the nose

Sometimes the bruising that occurs due to the leaking blood under the skin after the rhinoplasty operation may remain as a color change for weeks and may disappear. However, sometimes very long-lasting color changes may occur due to subcutaneous healing problems or ocal subcutaneous infections. In some patients, there is no problem in the nasal skin in the early period; After months, skin color changes and roughness can be seen. This is more likely to occur in revision rhinoplasty.

Intermittent inflammation and discharge on the skin of the nose

Especially with permanent (non-absorbable) suture materials, various foreign body reactions and inflammatory discharges can be seen due to sutures placed close to the skin. Normally, when reactions due to non-absorbable sutures occur, these suture materials become superficial and are expelled from the skin. If these suture materials are fixed to the cartilages in the deep tissue, foreign body reactions and inflammatory discharges from the skin may occur intermittently before the suture can be removed from the skin. In the video above, it can be seen that the local anesthetic drug injected before the operation spurts out of the skin from these areas and these suture materials are detected in areas with inflammatory discharge during the operation.

In patients with very thin skin, roughness and small protrusions can be seen on the long back after rhinoplasty!

The section where patients with very thin skin features are generally advantageous can be listed as faster recovery of the nose, faster recognition of the techniques applied during the rhinoplasty operation and the grafts used, and the disappearance of edema much faster. However, however; In patients with thin skin features, even very small amounts of healing tissues that may occur after surgery, such as small healing tissue on the nasal bone, callus formation, small roughnesses on the cartilage, suture reactions can be easily noticed from the outside. If the corners on the nasal bone, asymmetric small protrusions, veins passing through the skin can be easily seen, even before the operation is performed, in patients who come for an interview before the rhinoplasty operation; We inform our patients that there may be roughness on the nasal dorsum after the surgery, and sometimes in patients with very thin skin features, we may prefer to place the temporal muscle fascia under the skin. We can obtain consent from our patients for this. The temporal fascia used here, taken from the temple area, can provide a very bloody, natural barrier, camouflage effect of the patient, so that the roughness is not seen and the ridge of the nose is smoother.

Please do not smoke in the early period after complicated nose surgeries and eat healthy!

Especially after complicated rhinoplasty operations, it is necessary to have sufficient blood circulation, to have a clean and healthy intranasal mucosa, to have a strong general body resistance, to take sufficient protein and vitamins and minerals so that the cartilage tissue and bone tissue of the nose can heal quickly and healthily. In general, a factor that can seriously affect the recovery after nose surgeries is smoking. The nicotine in cigarette smoke causes the diameter of blood vessels to decrease and blood circulation to decrease. Again, carbon monoxide in cigarette smoke can cause a serious decrease in tissue oxygenation. Tar and burn product particles in cigarette smoke can adhere to the nasal mucosa and nasal skin, making it an environment prone to infection. For this reason, it is very important not to come into contact with cigarette smoke and not to smoke after nose operations. Smoking can cause serious graft infections, skin infections, infections in the mucous membranes, and color changes in the nasal skin, changes related to infections, especially after complicated revision rhinoplasty operations with previous recurrent nose surgeries and serious graft applications. Some of our patients have statements such as "I eat healthy and I wash the inside of my nose with a sufficient amount of ocean water spray, so I think that cigarette smoke will not harm me too much". The negative health effects I have listed above that can be caused by cigarette smoke cannot be eliminated by simply spraying the nose or consuming enough healthy food by mouth! For example, if an infection starts in the nose after the revision rhinoplasty in which rib cartilages are used, and if it causes deformation in the cartilage grafts or causes a change in the structure of the skin, it may cause problems that cannot be reversed and can not be resolved with simple treatments. In this regard, it is very important that you pay attention to the recommendations of our surgeon who performed the surgery.

Do not use powder-based make-up products or oily skin care products that close the pores of the nose skin after the rhinoplasty operation!

In the early period after the rhinoplaty operation, you can use ocean water sprays and make-up removal cottons to clean the nasal skin. Generally, in the first few months, powder-style make-up products should not be used on the nose as much as possible and the nose skin should be kept clean as much as possible.

Likewise, it is appropriate not to apply oily skin creams and other oily skin care products on the nose in the early period, which may act as a barrier on the nose and cause reduced air contact. Some of our patients can use products such as St. John's Wort oil, black cumin oil or essential oil during the nasal massages that can be done after rhinoplasty. The use of oil-derived products during massages, which can last for about 30 minutes or 1 minute, does not cause any problems.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

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