Concerns About Rhinoplasty: Orange Nose Bridge and Nasal Septum Issues

Nasal bridge appears orange, with small protruding granules on the nasal septum?

Hello Doctor: I underwent I-shaped cartilage rhinoplasty using ear cartilage about 5 years ago.
Since then, my nasal bridge has developed an orange hue, and there is a protrusion on my nasal septum that does not cause any sensation when pressed.
I personally consulted the surgeon, who simply stated that the orange color is a normal phenomenon due to thinner skin, and that the protrusion is likely cartilage that can be surgically removed.
However, the doctor did not perform a physical examination or provide any diagnosis, only suggesting that it might be cartilage that could be removed, which has left me concerned that the nasal implant might be protruding through the skin.

I would like to know what type of facility or hospital I should seek for further evaluation or treatment if I have concerns.
Most recommendations suggest returning to the original hospital, but my clinic has been unresponsive and has delayed my inquiries.
Additionally, what is the approximate cost for removal? I have read online that if ear cartilage is involved, the removal can be complex and may damage surrounding tissue, potentially leading to indentations post-surgery.
Is this true? Thank you for taking the time to read my lengthy message.
I apologize for the length.
Wishing you a wonderful day.

Cai Xiaojie, 20~29 year old female. Ask Date: 2019/02/26

Dr. Zhou Hongzhang reply Plastic Surgery

1.
This situation is indeed a bit tricky.
The nasal model (Carmela) and the transplanted cartilage may be causing this phenomenon (skin discoloration and protrusion of the nasal septum).

2.
The difficulty of removing the Carmela is indeed higher, but it does not necessarily damage the original tissue.
After removal, it may not necessarily result in a depression.

3.
It may be worth considering removal first and then evaluating later whether to undergo rhinoplasty again.

4.
Most plastic surgeons (as opposed to general aesthetic practitioners) can assist with the removal (both in clinics and hospitals).

5.
The cost can vary; each provider is different, ranging from several thousand to tens of thousands, depending on the complexity of the procedure.

Reply Date: 2019/02/26

More Info

It sounds like you're experiencing some concerning symptoms following your rhinoplasty, specifically the orange discoloration of your nose bridge and a noticeable protrusion of the nasal septum. These issues can understandably lead to anxiety, especially when you feel that your concerns have not been adequately addressed by your original surgeon.

Firstly, the orange discoloration you mentioned could be attributed to several factors. One possibility is that the skin overlying the nasal bridge is indeed thinner due to the surgical procedure, which can make underlying structures more visible and lead to changes in pigmentation. This is not uncommon, especially in areas where implants or grafts have been placed. However, it is essential to rule out other causes, such as infection or an allergic reaction to the materials used in the surgery.
Regarding the protrusion of the nasal septum, it is possible that the ear cartilage used in your rhinoplasty has shifted or that the healing process has resulted in some irregularities. If the protrusion is indeed cartilage, it may be a result of the surgical technique or the way your body has healed. While your surgeon suggested that this could be addressed surgically, it is crucial to have a thorough examination to confirm the diagnosis before proceeding with any further intervention.

If you have concerns about the original surgeon's response and the lack of follow-up, it may be beneficial to seek a second opinion from another qualified plastic surgeon or an otolaryngologist (ear, nose, and throat specialist) who specializes in rhinoplasty. Look for a surgeon with experience in revision rhinoplasty, as they will be more familiar with the complexities that can arise from previous surgeries. They can perform a physical examination, possibly including imaging studies, to assess the situation more accurately.

In terms of costs, the price for revision rhinoplasty can vary widely depending on the complexity of the case, the surgeon's experience, and the geographical location of the practice. Generally, you might expect costs to range from a few thousand to several thousand dollars. It is advisable to discuss the financial aspects upfront during your consultation.

As for the concern about the removal of ear cartilage and the potential for complications such as damage to surrounding tissues or the formation of depressions in the nasal area, these are valid considerations. While it is true that removing cartilage can sometimes lead to irregularities, a skilled surgeon will take care to minimize such risks. It is essential to have a detailed discussion with your surgeon about the potential outcomes and complications associated with the procedure.

In summary, your concerns are legitimate, and seeking a second opinion is a prudent step. Make sure to choose a surgeon who listens to your concerns, provides a thorough examination, and discusses all potential risks and benefits of any proposed treatment. Your health and peace of mind are paramount, and you deserve to have your questions answered comprehensively.

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