Infected alloplast removal

Previously, all rhinoplasty surgeons recommeded delaying revision rhinoplasty at least 6 months after removing infected alloplast. They all considered doing simultaneous rhinoplasty after infected alloplast removal raises the risk of another infection.

From the patient's point of view, delaying surgery causes a lot of problems. They have to wait at least 6 months with the nose disfigured and social activity restraints. The skin will shrink after implant removal, which causes difficulty in later revision. This pattern of surgery also costs more money than simultaneous revision rhinoplasty.

I have tried simultaneous revision rhinoplasty using autologous tissue when removing infected alloplast removal. I thoroughly removed infected tissue with currettage, irrigate with antibiotic solution, and reconstruct the nose with autologous tissue such cartilage, perichondrium, fascia, and periosteum. Fine tuing of soft tissue is sometimes difficult because the tissue is slightly edematous and damaged. The chance for reinfection is also considered higher than doing surgery in clean filed. However, I have found in more than 95% of my simultaneous reconstruction cases, there was no infection and the aesthetic result was also good. Above of all, the patient does not need to wait with social activity restraints and they can immediately go back to their daily life!

I would not hesitate to simultaneously do dorsal augmentation using autologous tissue when I have to remove the infected alloplast removal. I hope my results will help surgeons change their way of practice when seeing patients with infected alloplast.

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Deviated & hump nose correction

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