If pus is confirmed a year after nose surgery — the treatment order for chronic inflammation and revision judgment

2024. 5. 28.

If a fluid-pooling feeling persisted on the dorsum after nose surgery and pus was confirmed on ultrasound — why culture testing and antibiotics come first, the order of silicone removal·irrigation then a 6-month wait when antibiotics don't respond, and why autologous tissue is used for revising an inflamed nose.

Key points

Even without pain·odor·redness, if a fluid-pooling feeling on the dorsum persisted long, you may have been living in a chronic inflammation state.
If pus is confirmed, testing which bacteria it is and eliminating inflammation with matching antibiotic treatment comes first. If it doesn't respond to antibiotics, the silicone is removed and irrigated, then revision may be done after 6 months.
Revision of an inflamed nose usually uses autologous tissue — both bridge and tip can be done with autologous rib cartilage, and if a hard feel is disliked, surgery with autologous dermis is also possible.

"About a year ago I had nose surgery with silicone, and around 4~5 months the hump on my dorsum got worse. When I touch it, it feels like fluid is pooled — but there was no pain, odor, or redness. While getting revision consultation, ultrasound confirmed it was pus, and they say there's some contracture too. Did the silicone not suit me and cause the pus?"

This was an actual question received. If symptoms have persisted since the 4th~5th month post-surgery, you may have been living in a chronic inflammation state for that whole period. This article organizes the answer on what to do first in this situation, and in what order revision is judged.

Why is it chronic inflammation when there's no pain?

Even without pain·odor·redness, if pus was confirmed, infection possibility can't be ruled out. In this case too, only the fluid-pooling feeling on the dorsum persisted before pus was confirmed on ultrasound — so treatment was needed based on the test result rather than symptom intensity.

If symptoms have continued since the 4th~5th month post-surgery, that whole period was spent in a chronic inflammation state. However, accurate judgment is best done by seeing directly — because the treatment plan can differ by inflammation degree, current nose shape, and contracture degree.

If pus is confirmed, what comes first?

Confirming infection scope and bacteria through direct examination, then judging the antibiotic treatment set by medical staff and the need for implant removal comes first. Don't take antibiotics on your own or set a revision schedule first.

Bacteria test — through a pus test, confirm which bacteria grew.
Antibiotic treatment — receiving antibiotic treatment matching the confirmed bacteria to eliminate inflammation comes first.
If no response — if it doesn't respond to antibiotics, the silicone is removed and irrigation proceeds, then revision may be done after 6 months.

Situation	Response
Responds to antibiotics after bacteria confirmed	Eliminating inflammation with antibiotic treatment comes first
Doesn't respond to antibiotics	Consider revision after silicone removal·irrigation then 6 months
During the treatment period	Contracture can occur — steady progress observation

A point of caution is that contracture can occur in the meantime. So progress must be steadily watched even during treatment. Revision's own judgment criteria can be seen in more detail in the revision guide.

What material is used to revise an inflamed nose?

For a nose that developed inflammation, surgery with autologous tissue is generally common.

Using autologous rib cartilage for both bridge and tip is fine, and if a too-hard feel is disliked, surgery with autologous dermis is also possible. Nose inflammation is a problem that occasionally occurs after nose surgery — get treated well, then move on to revision.

Summary — eliminating inflammation comes first

In a situation where pus is confirmed, before agonizing over the revision shape, confirming the bacteria and eliminating inflammation with antibiotic treatment comes first. If it doesn't respond to antibiotics, revision is considered after silicone removal and irrigation with time in between — and progress observation is needed because of contracture possibility in the meantime. Autologous tissue like autologous rib cartilage·autologous dermis is the common revision material.

If curious which order fits the current nose state, you can confirm directly in a 1:1 video consultation.

Frequently asked questions

Answers to common questions patients ask before a consultation.

Did the silicone not suit me and cause the pus?

Before concluding a cause, confirming which bacteria grew through a pus test comes first. Since the plan can differ by inflammation degree, current nose shape, and contracture degree, accurate judgment is best done by seeing directly.

Can both bridge and tip be done with autologous rib cartilage?

Yes. For a nose that developed inflammation, surgery is usually done with autologous tissue — using autologous rib cartilage for both bridge and tip is fine. If a hard feel is disliked, surgery with autologous dermis is also possible.

If the silicone is removed, how long does treatment take?

When it doesn't respond to antibiotics and silicone is removed with irrigation, revision may be done after 6 months. However, contracture can occur in between so progress must be steadily watched — the specific period can differ by inflammation and contracture degree.

Responses to treatment and recovery progress vary by individual. Outcomes and side effects vary from person to person. Bleeding, infection, swelling and asymmetry may occur. Please consult our medical team before making a decision.

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