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Introduction
Rhinoplasty is a surgical procedure which is usually indicated to improve the nasal breathing function and cosmetic appearance of the nose. Both aesthetic and non-aesthetic complications of rhinoplasty have been reported.1-3
Post-rhinoplasty infection of the nose is a much less frequently encountered complication, and is not well documented. Foda investigated 500 external rhinoplasty cases, and described a post-operative infection rate of 2.4 per cent.4When infection of the nasal tip occurs, it is expected to manifest within the first few weeks of nasal surgery. If not promptly recognised and appropriately treated, more morbid sequelae may result, such as abscess or necrosis of the nasal tip, bacterial meningitis, and cavernous sinus thrombosis.1Nasal tip abscess and necrosis may cause aesthetic problems, impede normal social contact, and create self-identity problems for affected patients.
This paper aims to describe what we believe to be the first reported case of nasal tip abscess with an adverse skin reaction to Prolene following rhinoplasty. To the best of our knowledge, and following a literature search, we are not aware of any previous reports of this unusual presentation of nasal tip abscess.
Case report
The patient was a 26-year-old woman who had undergone functional septo-rhinoplasty 2 years prior to presentation, in order to correct a nasal breathing obstruction caused by a shifted external nasal pyramid. Eight weeks after this septo-rhinoplasty, the patient had felt satisfied and comfortable (Figures 1a and 1b).
Fig. 1
The patient (a) before, (b) eight weeks after and (c) two years after septorhinoplasty, the latter showing the nasal tip abscess.
Six months after septo-rhinoplasty, the patient had complained for a short period of time about a subjective swelling sensation and a recurrent feeling of pressure at the nasal tip, but clinical examination showed no pathological findings.
Two years after her septo-rhinoplasty, the patient presented again with a painful, grossly disfigured nasal tip, which was swollen with redness of the overlying skin (Figure 1c). The nasal cavities were normal and showed no discharge. There were no similar swellings in other parts of the body, and no history of tobacco sniffing, nasal topical medication, diabetes mellitus or immunosuppression. Symptoms of rhinological, otological, ophthalmic, neurological, dental, neck...