Tip inflammation — what happens if it’s left untreated: early signals and the criteria for considering tip revision

01

What are the early signals of tip inflammation?

Swelling or redness appearing for a period after nose surgery is a relatively common process. But if the change persists even after a certain time has passed, there’s a possibility it’s a signal of tip inflammation. Typically the following changes appear.

• When tip redness persists for a long time
• When warmth keeps being felt
• A feeling of the tip gradually hardening
• Stinging or throbbing pain
• When a smell different from usual is felt inside the nose

Not all of these changes mean inflammation. But if symptoms persist even as time passes, checking whether it’s simple swelling or tip inflammation is needed.

02

What changes occur if tip inflammation is left untreated?

Caution is needed because the expectation that “it’ll be fine once time passes” can instead worsen the situation. If inflammation is endured with medication alone and left alone, the inside of the nose can change quickly.

If it spreads into chronic inflammation, internal tissue can go through a fibrosis process where it hardens like scar tissue. The hardened tissue then contracts, which can lead to contracture, pulling the implant and the tip upward. Eventually the nose’s length shortens and the nostrils become overexposed from the front, changing into an upturned, piggy-nose-like shape.

Once it reaches this stage, tissue damage is severe, so restoration itself becomes very difficult, and tip revision that builds the structure again may be needed.

03

By what criteria is tip revision considered?

Not all tip inflammation leads to revision. The treatment direction can differ by the degree of inflammation and the state of the tissue. If inflammation is at an early stage, there are also cases that stabilize with medication treatment or care. But if inflammation recurs or tissue change has begun, revision that removes the implant acting as the cause and builds the nasal structure again may be needed. What is checked before revision can be seen in more detail in the nose revision guide.

The principles kept in revision are as follows.

• Complete removal of the causative implant — cleanly removing the existing silicone that is the source of the inflammation and precisely clearing the surrounding contaminated tissue.
• Use of autologous tissue — when there has been a rejection response to an artificial implant, approaching with one’s own tissue such as autologous rib cartilage, septum, or autologous dermis to reduce the foreign-body-reaction burden.
• Timing — if infection is severe, the principle is to wait at least 6 months after removal for tissue to stabilize before reconstructing. Because a safe result comes before a hurried mind.

In actual consultations there are many questions not only about the surgical method but also about rib-cartilage use and the surgical environment, so they’re organized together in the FAQ below.

04

Summary — checking whether it’s simple swelling or inflammation comes first

Changes appearing after nose surgery are in some cases ones that stabilize naturally as time passes. But if tip redness, warmth, or pain recurs, a process of checking whether it’s simple swelling or tip inflammation is needed. If you’re worried about a change in your nose, rather than judging alone, I recommend first checking the current state of the nose and any tissue change.

If your tip’s current state worries you, you can get the current state confirmed in a 1:1 video-call consultation. Contracted-nose revision cases can be seen in before-and-after photos.