Lump on the back of the nose after rhinoplasty. Common problems after rhinoplasty

ID: 1620 55

Having undergone rhinoplasty, I came across some important points that are not written about on the Internet, but the final result of the operation largely depends on them.

Many patients who have already had surgery begin to worry about the issue of scars.

On various sites, in the description of rhinoplasty, it is written that there are two types of operations - open and closed rhinoplasty, with open rhinoplasty an external incision is made in the columella area, the scar with open rhinoplasty, although visible, is almost invisible and disappears completely after about a year, and with With the closed approach there are no visible scars. All this is true, but... there are some nuances that relate to subcutaneous scars during closed rhinoplasty. That’s why I wanted to get more information about them. I received the answers from my plastic surgeon, Andrei Ruslanovich Andreishchev, and below I tried to convey his words.

It doesn’t matter whether you perform open or closed rhinoplasty, tissue dissection occurs in any case. In the very place where the rupture is made, blood collects after the operation, this blood is then gradually replaced by scar tissue. There may be a thickening in the place where the scar formed. This point is very important for the nose, especially if the patient has thin skin. This thickening can create unevenness and a wide back, wide tip. For many patients, a particularly “dangerous” place is above the tip of the nose, where the thickest scar is formed, due to which a certain orientality of the nose may appear, which is not common among the Caucasian race.
What should be done to prevent this?
Firstly, be as careful and as gentle as possible to injure the tissue.
Secondly, the fight against swelling. This is a plaster cast, exclusion of physical activity, steam rooms, saunas, etc. This is done because during swelling the skin thickens and the scar forms more noticeable. You also need to ensure that there is no additional damage or hematome.

If a scar does appear (and it manifests itself in the form of a small, easily palpable and sometimes visible thickening or bump), the doctor can influence it within six months while it is forming - make it smaller, thinner, more accurate. To do this, special injections are made into the scarring area.
With closed rhinoplasty, it is easier to control scarring than with open rhinoplasty. And although it is believed that scar formation takes six months, in reality rhinoplasty takes slightly longer. And if you look at photographs of patients 8-10 months after surgery, there are still minimal changes.

I hope that this information will be useful to someone, and that I did not convey the doctor’s words in a very clumsy or distorted way.

Of course, there are plenty of examples when the patient is already fine and has never received any magic injections and has never heard of scars, but I myself am not one of those lucky ones, but a classic example of a patient with thin skin. Having had rhinoplasty, at the beginning I had no idea why I needed to fight swelling so much, I thought it was just so that my nose would quickly take on its final form, that the swelling would go away anyway in six months, and when the doctor gave me the first injection in that same I thought that the “dangerous” zone at the tip of the nose was just a little whim, so that the swelling would go away faster and the nose would acquire its beautiful straight appearance. But when, a month after the operation, a lump suddenly appeared on the back of my nose, on the side of the place where the hump used to be, and below the depression, I panicked. I thought I hurt my nose. It was then that I heard for the first time such a phrase as “a subcutaneous scar began to form.” Even though the doctor reassured me, I was still worried that the lump was not going away. Andrei Ruslanovich gave me injections almost every month for six months at the tip of my nose, this area worried him more, and only twice in the area of the bump. He said that when the scar is formed, the nose will become denser and the bump will not be noticeable, and so it happened, already in the third or fourth month after the operation, it became almost invisible in appearance, it could only be felt a little, and then gradually the nose really became denser and she stopped being noticeable and bothering me. The tip also became straighter.

In the first photo you can still see that very “dangerous” area that so often worries patients, where I was given injections.

In the second photo, the place where the bump was is indicated; it is not noticeable, but the depression in the picture is still visible.

I would like to advise those who are going to have rhinoplasty, trust your face only to the most experienced surgeons!!! After all, removing a hump does not mean making the nose beautiful; it is also important that the incision itself during the operation is neat and that no complications arise later. And after undergoing the long-awaited operation, follow the instructions and regularly go for check-ups with your doctor. Let him finish his job and perfect your nose!

When planning to change something in your appearance, you should pay attention not only to the desired result, but also to the possible difficulties of the recovery period, as well as ways to avoid them.

Callus after rhinoplasty- these are growths on the outer and inner sides of the nasal skeleton caused by its damage during surgery. They appear if an osteotomy has been performed, and in some cases require additional treatment, including repeated surgery. Why do such formations arise and what is their function? Can they pass on their own? Are there reliable methods of prevention? The site studies the information and shares its findings:

How and why is callus formed?

It is normal for our nose to heal after damage, incl. surgical, occurs in several stages:

Initially, a fibrocartilaginous skeleton grows on the injured area, the main task of which is to hold the broken bones in the most motionless position. This is a callus, and it appears both on the outside of the damaged area (periosteal) and on the inside (endosteal).
The formation will increase in size until it ensures reliable fixation of bone fragments: the less mobile they are initially, the faster growth will stop. Externally, it may look like irregularities and bumps on the bridge of the nose, a sudden hump, asymmetry of the sinuses, etc. - depending on the exact area where the surgical injury occurred. In uncomplicated cases, this stage takes 2-4 weeks.
The next step is the formation of the so-called. intermediary callus - it arises between adjacent parts of damaged bones and gradually grows them together, grows with blood vessels, thereby ensuring complete healing. This process is not visible from the outside; its progress can only be judged by X-ray data.
After 6-8 weeks, the fusion ends, after which the periosteal and endosteal growths that have fulfilled their functions are significantly reduced, and in many cases, they resolve almost completely. There are no noticeable deformities of the nose, if there were any during the healing period.

Thus, the appearance of callus after rhinoplasty is an absolutely normal phenomenon that contributes to the proper healing of damaged areas. With good fixation of the fragments, the entire process takes no more than 2 months, leaves no visible marks and ends with the formation of full-fledged nasal structures that are resistant to external mechanical influences and fractures.

Problems arise if the periosteal growths grow too actively in size and become denser. This may happen for one of the following reasons:

The cartilage and bones with which the work was carried out are poorly fixed and are in constant movement - for example, due to an incorrectly applied bandage.
The patient’s violation of the surgeon’s recommendations in the early postoperative period: any external influences on the nose, attempts to scratch it under a cast, severe sneezing, active physical activity, etc. lead to displacement of bone fragments that have just begun to fuse and enlargement of the callus.
Traumatic surgical technique. The more damaged the skeletal part of the nose was and the less gentle methods of its reconstruction were used, the higher the chances of complicated healing.
Individual characteristics of the body. In some people, the tendency to increased growth of cartilage and fibrous tissue is genetically determined - similar to the tendency to form keloid scars.

Healing in such conditions takes much longer - up to six months or more; the periosteal formation often grows excessively large and massive, and does not decrease even after complete fusion of all bone structures, leading to visible changes in the shape and contours of the nose.

Is it possible to remove it and how to do it?

As a rule, patients begin to panic 1-2 months after surgery, when, firstly, the callus reaches its maximum size, and secondly, the main swelling goes away and you can begin to examine your new nose in all details. But if during routine examinations the surgeon does not see any “crime” (for example, excessive growth of bone tissue), then there is nothing to worry about. Any formations that form during the recovery period after a nose job may go away on their own - doctors recommend waiting 6 to 12 months before doing anything else.

However, sometimes already in the first weeks of rehabilitation it becomes obvious that the growth is growing too rapidly - an experienced doctor can easily diagnose this situation during a face-to-face appointment. In this case, it is better not to delay treatment in order to avoid further surgery. The first step is usually to prescribe one of the following drugs:

Diprospan. It is used in the form of subcutaneous injections. The effectiveness of the product is associated with its ability to reduce the severity of inflammatory reactions, thereby preventing the formation of large periosteal growth.
Kenalog. It is administered intramuscularly. Belongs to the group of corticosteroids. The main active component is triamcenolone acetonide, like Diprospan, it has an anti-inflammatory effect and softens connective tissue.
Traumeel S. For this reason, a homeopathic remedy is used extremely rarely in surgical practice. It is used both externally as an ointment and internally (tablets, drops). The effectiveness has not been scientifically proven, but has been confirmed by clinical observations.

In addition, physiotherapy may be prescribed: ultrasound treatment of the problem area using steroid ointment, etc. – such procedures also reduce the severity of inflammation and the size of the developing callus.

A follow-up examination is carried out ~1 year after surgery. By this time, any growths on the outside of the nose should have resolved. If defects remain, further treatment tactics are selected based on their size and impact on the aesthetic result of the operation:

Small irregularities caused by the presence of periosteal formation can be corrected with the help of fillers (for more details, see the article “”). Injections provide a temporary result and the procedure must be repeated every 6-8 months - as a rule, this option is used as a temporary one, while awaiting surgery or if there are contraindications to it.
The main way to remove old callus is repeated surgery, which involves mechanical removal of the growth. It is performed under general anesthesia, but is otherwise considered much easier and safer than primary rhinoplasty. The osteochondral skeleton of the nose is practically not injured, therefore the risk of relapse is reduced to zero.

Hypertrophy of fibrocartilaginous tissue after rhinoplasty can be prevented. Much depends on the surgeon - during the operation he must make careful, low-traumatic incisions, and then correctly align and fix the bone fragments, ensuring their complete immobility. Therefore, the choice of a specialist and his qualifications should be taken very seriously.

Also, the patient must strictly follow the rules of the postoperative period. There are few of them, but they are all important:

in the first three days, keep to bed rest;
in no case should you remove or loosen it yourself, climb under it with your hands or foreign objects to scratch yourself, etc.;
for 7-14 days after surgery, minimize physical and emotional activity: do not go to the gym, take time off from work;
in the first two weeks, clean your nose exclusively with cotton swabs or turundas - blowing your nose is strictly prohibited;
do not expose your face to frequent and prolonged exposure to high temperature: bathhouse, beach, sauna, bath are prohibited for you for a month;
protect the postoperative wound area from hypothermia;
If you wear glasses, replace them with contact lenses for at least 2-3 weeks.

Despite the popularity of rhinoplasty, its consequences can be very serious and may not appear immediately. Sometimes it takes several months, or even years, for a problem to form - and when a person has forgotten to even think about the operation, he suddenly develops breathing problems or his nose “moves” to one side. Moreover, these complications occur most often, and in about 15% of cases another operation is necessary to correct the nose.

Infections practically never happen, and psychological disorders and complications that appear immediately after surgery take second place. All of them require urgent intervention from a doctor of the appropriate profile.

In addition to severe complications, there are minor health problems that can be resolved quickly and without harm to the patient. Approximately 30% of operations are accompanied by side effects.

Causes of complications

Causes of complications:

Choosing the wrong one doctor Little experience in performing operations increases the possibility of surgeon error.
Ignoring requirements attending physician. Failure to comply with the regimen, refusal to use medications, physical actions that can damage the nose - all this leads the patient to the need to undergo surgery again.
Individual intolerance drugs used during surgery.

Rhinoplasty is not only a quick operation and recovery over several months, it is a long preparatory period, during which you need to select the desired shape and coordinate it with the doctor. This step should not be skipped, as the result may not be what the patient expected.

If possible, you need to make an approximate model of the future nose - modern technologies allow this.

Consequences

Doctors identify several main types of problems that a patient who has undergone rhinoplasty may encounter:

Aesthetic. If there is no threat to the patient’s health and life, but, nevertheless, something went wrong, this relates to the aesthetic side of the issue. If the nose has become larger after rhinoplasty, or a hump remains after the operation, the problem is clearly an aesthetic one.
Functional. Sometimes they are confused with aesthetic ones because they do not look very attractive. But there is also a difference: with functional problems, a person cannot breathe through his nose or experiences certain difficulties in identifying odors.
Infectious. Redness of varying degrees of severity, swelling. They are not so common, but can be accompanied by high fever and serious condition of the patient.
Psychological. They usually appear in combination with other problems, but there are cases when the patient’s poor emotional state is not caused by anything. People are afraid of how their new appearance will be perceived by others.
Specific. They are associated with the individual characteristics of the patient’s body and cannot always be predicted.

If we talk about serious consequences that can harm the patient’s health, the following situations should be highlighted:

Damage cartilage or skin.
Damage bones.
Bleeding during or after rhinoplasty.

In the first case, after surgery there is a high probability of scars and adhesions, the elimination of which will require additional surgical intervention after the nose has healed. In the second: the nose may shift or bend to the side; corrective surgery is usually required more often.

In the third, the problem is controlled with the help of medications and cotton swabs.

Early consequences

Unsuccessful nose surgery can lead to the following consequences, noticeable within a few hours after the procedure.

Seam divergence

It appears if the incision was made poorly, or if the surgeon used low-quality material for stitching. Sometimes discrepancies occur spontaneously, regardless of the quality of the material.

The main thing is to tell your doctor about the unpleasant sensations in a timely manner so that he can adjust the course of treatment and refer you for a repeat operation. If you put it off “for later,” there is a high probability of deformation of the nose or the appearance of unhealed scars.

Hematomas

Hematoma after rhinoplasty is absolutely normal. During nose correction, incisions are made, and in particularly complex operations, bones are crushed - damage cannot be avoided.

Crusts

Crusts in the nose after rhinoplasty are caused by blood entering the nasal cavity. This environment is favorable for the development of infection, so the doctor must be notified of difficulty breathing. He will prescribe treatment to clear your nose.

The crusts must not be torn off! They should peel off on their own.

Blue streaks or bruises

Blue streaks after rhinoplasty (especially after complex operations) are caused by a small amount of blood getting under the skin. If they do not grow and no more bruises appear, you need to wait until they go away on their own; if the skin is very delicate, the bruises can last more than a month.

Runny nose

A runny nose does not appear very often and goes away quite quickly. Under no circumstances should you blow your nose.

The doctor will show you how to carefully deal with the problem using napkins or cotton swabs. It is advisable to sneeze with your mouth open.

Numbness

Any plastic surgery can lead to loss of sensitivity. During rhinoplasty, the tip of the nose or some part of it may become numb - it all depends on the area of the procedure and the professionalism of the surgeon.

Sensitivity often returns; you have to wait a few days. If numbness occurs several months after surgery or does not go away even after discharge, you should consult a doctor again.

Humpback

A hump after rhinoplasty may appear due to callus, swelling or doctor error. In any case, the algorithm of action is simple: if the swelling has subsided, but the hump remains, you need to wait until the doctor authorizes the operation again.

Difficulty breathing

To restore nasal function, you need to ask the surgeon to prescribe certain medications or, if the swelling does not go away, to conduct additional examination and surgery.

Infection

If the disinfection of the room, instruments or the operated area was not sufficient, infection may enter the sutures. To exclude this possibility, it is recommended to be under the supervision of a doctor for at least the first few days. This will be useful: at the first sign of infection, such as fever, the doctor will prescribe antibiotics.

Necrosis

If the surgeon made a mistake during the operation or something unexpected happened, causing blood to stop flowing to part of the nose, tissue necrosis may develop. This leads to the need to remove the affected part of the nose. Such cases are very rare in practice.

Temperature

If the temperature stays in the range of 36 to 38 degrees for the first few days, then everything is fine, but if it increases or lasts for several weeks, you should think about returning to the hospital and checking the stitches for infection.

Pain

Pain after rhinoplasty will appear almost immediately after surgery. This is fine. It is usually tolerable, but if you have a low pain threshold, you may want to talk to your doctor about prescribing appropriate medications. Self-administration of medications is not recommended, especially if you are taking other medications due to other complications.

Consequences that are visible to the naked eye

Aesthetic complications:

Curvature back of the nose.
Asymmetry. To understand, you need to divide the nose into two parts and see if the parts are the same. You may end up with different nostrils.
Coracoid Deformation of the nose is when the nose is very full above the tip, and the tip itself is disproportionate to the rest of the part and is often curved down.
Lowered/ excessively upturned tip of the nose.
Shortened tip nose
Saddle deformation. The bridge of the nose sags approximately in the middle. With pronounced deformation, the angle of subsidence is significant, visible to the naked eye, and the tip of the nose protrudes noticeably. The skin at the site of deformation becomes mobile and folds without effort.

Late consequences

Not all effects appear immediately; some may take several months or a year to appear.

Changing the shape of the nose

Over the course of a year of complete rehabilitation, the shape of the nose may change slightly - this is included in the risks of rhinoplasty. Almost half of all reoperation cases are due to beak deformity.

A nasal tip that is too upturned or drooped can also be a reason for repeat surgery. The following table shows the main mistakes that can be made and their consequences:

Error	Example	Result
Technical error (not too serious)	Incorrect placement of the graft	Asymmetry after rhinoplasty or irregularities visible to the naked eye
Deformations left unattended	Deformities of varying severity	Deformation
Doctor's recommendations ignored	Deformation of the tip of the nose	Beak-shaped deformity or drooping nasal tip
Hypercorrection	Bridge of the nose	Too short nose, saddle deformity

Callus

Its appearance is due to improper fusion of tissues inside the nose. There is always such a risk, and if the doctor notices a callus during an examination, measures must be taken before it grows and begins to cause pain to the patient. As the callus grows, a hump may appear.

Bumps near the eyes

Specific reaction of the periosteum to damage due to surgery. It can only be corrected by contacting a surgeon. It appears no earlier than after a few months.

Nasal congestion

After rhinoplasty, patients often complain that their nose is stuffy. This is a common symptom. It goes away on its own after 3-5 days.

But experts note that this unpleasant sign can bother you for several months. This does not apply to deviations. The patient only needs medical supervision.

Swelling after tip plastic surgery

Swelling after rhinoplasty of the tip of the nose occurs as a result of soft tissue injury. Highlight:

Primary. Occurs during surgery.
Secondary. Swelling is less pronounced. Observed after rhinoplasty.
Residual. Outwardly almost invisible.

The swelling disappears completely after a year, as soon as blood circulation in the tissues of the nose is restored. The duration of the rehabilitation period depends on the volume of surgical intervention, the patient’s age, and the physiological characteristics of the body.

Smell

Loss of smell is also a common symptom after rhinoplasty. It goes away on its own immediately after the swelling decreases.

Nasal breathing and sense of smell are usually restored after 1-2 months.

But the most dangerous sign is the appearance of a putrid odor in the nose. This indicates that postoperative complications have begun and the patient requires the help of a doctor.

The cause of the formation of purulent masses is infection of the wound surface, penetration of bacteria onto the injured mucosa.

The putrid odor may also be noticeable to others. To prevent the occurrence of such a symptom, you should follow the recommendations of a specialist during the rehabilitation period.

After which the help of a doctor is required

Bruises usually go away very quickly, but some complications should be dealt with by a high-level specialist, preferably an experienced surgeon. His help should consist not only in placing cotton swabs and prescribing tablets, but also in repeated consultations and, if necessary, surgical intervention.

List of main complications after which reoperation is inevitable:

Abscess.
Atrophy cartilage.
Dysfunction breathing.
Intracranial complications after rhinoplasty.
Perforation partitions.

How to reduce the likelihood of complications

In order not to get a deformed nose after rhinoplasty, you need to carefully think through everything down to the smallest detail. You need to choose the best clinic and doctor.

An unsightly scar after rhinoplasty may appear due to non-compliance with the doctor’s basic recommendations during the recovery period. To prevent this from happening, it is necessary to write down all the surgeon’s instructions and not deviate from them.

Kira (34 years old, Nakhabino), 04/09/2018

Good afternoon Tell me, is it normal if after rhinoplasty I have a low temperature for several days? They didn't warn me about this at the hospital!

Hello! A slight increase in temperature after surgery is normal. Typically, in the first two to three days after surgery, the temperature remains at 37-37.5 degrees. The temperature should drop on the third day after rhinoplasty. If this does not happen, we advise you to contact the clinic where you were operated on.

Georgy (36 years old, Moscow), 03/21/2018

Hello! Please tell me, is it possible to return the nose to its previous shape after a bone fracture? Thank you!

Hello! Yes, rhinoplasty allows you to return the nose to the desired shape, but plastic surgeons do not work with bones. Rhinoplasty can only visually improve the shape of the nose, make it smaller or change the shape of the nostrils. ENT surgery will help change the bone.

Vigen (32 years old, Moscow), 03/18/2018

Tell me, how long does it take for the nose to heal after plastic surgery?

After surgery, bruising and swelling may occur, which may spread to the eyes or other parts of the face. Swelling goes away in 7-10 days. At this time, physical activity and exercise are not recommended. Immediately after the operation, bleeding (from the nose) may occur, but this is only a consequence of soft tissue trauma. Bandages, as well as splints, are removed 14 days after surgery, and tampons are removed during this period. Some patients experience severe pain when removing tampons, so pain medication is often used. Within a month, you can observe swelling of the mucous membrane, so breathing will be difficult. After the swelling goes away, breathing will resume. On average, the result after surgery can be assessed after 6 - 8 months. In rare cases, the result of the operation is assessed after 12 months.

Alevtina (24 years old, Moscow), 09.15.2016

Hello, Maxim Alexandrovich! I have a very small nose. Is there any way to increase it? Will this affect breathing?? Thanks for your answer, Alevtina.

Hello, Alevtina! Rhinoplasty can help solve your problem. We can enlarge your nose, maintaining its shape or changing it based on your desire. Come to us for a consultation and we will discuss the expected results of the operation. Rhinoplasty will not disrupt the respiratory processes, since the structure of the nasopharynx is taken into account during the operation.

Alexey (30 years old, Moscow), 09/13/2016

Hello, Maxim Alexandrovich! Is it possible to correct facial asymmetry (due to a strongly curved nose to the right) with rhinoplasty? Thanks for the answer, Alexey.

Hello, Alexey! In practice, rhinoplasty will help you regain symmetry, but an in-person consultation is necessary to get an accurate and clear answer to your question. You can make an appointment with us and we will conduct a full examination and discuss the likely outcome of your rhinoplasty. It is also important to understand whether the nose is crooked from birth or due to injury

Lyubov (35 years old, Moscow), 09/06/2016

Hello, Maxim Alexandrovich! My daughter has a very large nose and she suffers greatly because of it. Is it possible to have rhinoplasty at 15 years old? How will surgery be different at this age? Thanks in advance, Love.

Hello, Love! Unfortunately, rhinoplasty is performed only from the age of 18. The reason for this is the growing up and formation of the child’s body. The formation of the skeleton is completed, and this process must be completely completed before surgery occurs. Try working with a psychologist, and then come for a consultation when your daughter turns 18.

Evgenia (25 years old, Moscow), 09/01/2016

Hello, Maxim Alexandrovich! Is it possible to straighten a displaced septum and remove the hump at the same time? Problems arose after a broken nose. How long will rehabilitation last? Best regards, Evgenia.

Hello, Evgenia! Yes, it is possible to carry out both operations at the same time. Only in rare cases are two stages prescribed, which are carried out with an interval of one month. The postoperative period takes about two weeks, during which time bruising and swelling should subside. Hospital stay usually takes no more than three days.

Olga (22 years old, Moscow), 08/30/2016

Hello, Maxim Alexandrovich! I heard that the result of rhinoplasty can be affected by the condition of the skin. This is true? If I have problem skin, should I not have rhinoplasty? Thanks in advance.

Hello! Yes, the condition of the skin is one of the factors that are taken into account before undergoing surgery. The fact is that poor skin condition can lead to unpredictable complications during the rehabilitation period. You can undergo treatment with a dermatologist, and after that make an appointment with us for a consultation, where we will discuss the advisability of surgery.

Hello, Galina! There are two types of rhinoplasty: open and closed. In the first case, a barely noticeable mark may remain on the septum, but with proper care they disappear after some time. In the second case, all manipulations are carried out without violating the integrity of the skin. Which type of rhinoplasty is appropriate in a particular case is decided only by a plastic surgeon after reviewing the tests and examination.

One of the complications of rhinoplasty surgery is the appearance of hypertrophied callus. But not everything is so simple.

In fact, with the appearance of such a callus, the body reacts to tissue damage due to its enormous compensatory capabilities.

The growth of excess bone fibers at the site of surgery is the body’s reaction to injury.

Bone callus is the result of regenerative processes; its occurrence occurs as a result of the natural restoration of bone tissue after its destruction.

There is no need to confuse an ordinary callus, for example, on a finger, and a bone callus - these are completely different formations.

A callus consists of connective tissue that appears at the site of bone fusion. That is, such a callus, in fact, always forms, and this is a normal process.

It is important to prevent the appearance of an overgrown callus.

Such a callus is not dangerous for the body, but it also needs to be treated to prevent even more serious complications and the appearance of pain.

An important point: an overgrown callus can significantly deform the appearance, which completely neutralizes the result of the operation.

Stages of formation:

Initially (within about 7 days) after rhinoplasty, a provisional callus is formed.
Bone or cartilage tissue is then formed from the resulting osteoid tissue.
The formation of callus occurs within a period of up to 6 months.

The formation time depends on the following factors:

qualified and timely medical care;
the size of the damaged bone;
patient's age;
general condition of the patient’s body: features of metabolic processes,
condition of the nervous system and endocrine glands.

Callus can be of the following types:

periosteal;
intermediary;
endosteal;
paraosseous.

Briefly about each of them:

Periosteal - appears on the outer part of the bone. It has a good blood supply and, accordingly, is characterized by rapid regeneration.

It is expected by surgeons and causes a slight compaction to form along the fracture line. This is the so-called “good” callus, which must appear, otherwise the bones will not heal.

It functions as a kind of living glue that holds bone fragments together and allows new bone to grow.

The intermediary callus holds bone fragments together, filling the space between them with cells and vessels,

Endosteal– formed from bone marrow and endosteal cells, appears next to the bone marrow valve.
Paraosseous- this is a kind of “bridge” for fragments of bone tissue; it is soft tissue that is easily destroyed even under not so significant loads.

This type of callus is unfavorable, and surgeons during rhinoplasty try by all means to prevent its formation.

The type of callus depends on the location of the fracture and the individual properties of the body, the ability to regenerate tissue.

Video: Surgical technique

Reasons

The occurrence of callus is based on the special properties of bone tissue, which differs from other organs and systems in the unique course of the healing and restoration process.

The process is as follows:

formation of connective tissue around the damaged area;
formation of bone tissue in the form of thin fibers;
Calcification of fibers occurs, as a result of which bone tissue is strengthened, soft tissue is replaced by bone. Then, at the site of fusion of the bone tissue, a growth is formed, the size of which depends on the depth of the injury to which the bone and adjacent tissues have been subjected, as well as the patient’s body’s ability to regenerate tissue - this is an individual property.

Based on the above, among the reasons for the appearance of callus after nose surgery are the following:

the body’s ability to intensively restore bone tissue;
skill of a plastic surgeon: experienced professionals have
developments, the use of which in the overwhelming majority prevents the hypergrowth of bone fibers.

An important point: callus after rhinoplasty can develop only when the bone tissue is damaged during the operation, that is, the bone skeleton is corrected.

Most often this happens after removing a hump on the bridge of the nose and completely changing the shape of the nose.

Photo: Before and after surgery

How to remove callus after rhinoplasty

Hypertrophied growth of callus can lead to:

humps on the nose, nasal deformities;
edema

There are several methods to get rid of callus:

surgery (although it is prescribed relatively rarely);
physiotherapy;
treatment with medications.

Removal of callus is indicated as a last resort if other methods are not effective.

Surgical intervention is also indicated in the following cases:

high body temperature;
hyperemia, edema.

Drugs

To prevent the appearance of hypertrophied callus, drugs are used that contain glucocorticoid hormones, which remove swelling and promote rapid tissue healing:

drug "Diprospan" administered by injection, subcutaneously, improves the ability to scar, reduces inflammation, swelling;
drug "Kenalog" administered intramuscularly, has a pronounced anti-inflammatory effect;
homeopathic preparation of complex action "Traumel S", applied externally (ointment) and internally (drops, tablets).

Physiotherapeutic procedures

As a result of physiotherapy (although this is a long-term treatment), it is possible to activate the regeneration and gradual resorption of the callus:

electrophoresis is used using hydrocortisone and lidase;
ultrasound exposure using steroid ointment, phonophoresis;
magnetic therapy, UHF;
thermotherapy (heat therapy).

Prevention

The main measures to prevent the appearance of callus after rhinoplasty are:

strict adherence to the doctor’s recommendations during rehabilitation;
urgently contact your doctor if initial signs and symptoms of callus appear;
the optimal choice of clinic and experienced professional for rhinoplasty. The operation is quite common and has a relatively low cost, so it is important to navigate among all the offers in order to choose the best option without being tempted by a lower price than usual.

To prevent the occurrence of callus, as well as excessive swelling and other complications, you must follow simple rules:

the doctor recommends staying in bed for the first 2-3 days - do not ignore this requirement, because this will have a positive effect on your well-being and, ultimately, on the result of the operation;
during the postoperative period, it is better to stay at home for at least two weeks and avoid strong physical exertion;
do not blow your nose for the first two weeks (use special sticks to clean your nose);
do not visit the beach, sauna, solarium for at least a month, avoid excessive overheating and prolonged exposure to the sun;
do not do strength exercises or carry heavy weights for 2 months;
during the rehabilitation period there is no need to wear glasses (they put pressure on the bridge of the nose);
exclude both too cold and hot food and drinks, take food warm.

And one more thing - do not be afraid of bruises after surgery.

It has been noticed that the concentration of a small amount of blood in the osteostomy area results in the formation of a “positive” callus that holds the bones together for 7 to 10 days, and therefore there will be no need to use a plaster cast.

Hypertrophied callus does not appear very often after rhinoplasty. At the first sign of it, you need to consult a doctor, and then there is a high chance of removing the callus without surgery.

After all, repeated surgery also does not always guarantee that the problem of callus will not arise again.