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

Id: 1620 55

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

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

On different sites in the description of rhinoplasty it is written that there are two types of surgery - 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 there are no visible scars in the closed approach. All this is true, but ... there are some nuances that relate to subcutaneous scars with closed rhinoplasty. That's what I wanted to get more information about. I received answers from my plastic surgeon, Andrei Ruslanovich Andreishchev, and below I tried to convey his words.

It does not matter whether you do open or closed rhinoplasty, tissue dissection occurs in any case. In the very place where the rupture is made, after the operation, blood is collected, this blood is then gradually replaced by scar tissue. In the place where the scar formed, there may be a thickening. For the nose, this moment is very important, especially if the patient has thin skin. Such a thickening can create bumps and a wide back, a wide tip. In many patients, a particularly "dangerous" place is above the tip of the nose, where the thickest scar is formed, due to which some easterness of the nose may appear, which is not accepted in the Caucasian race.
What should be done to prevent this?
First, as carefully and gently injure the tissue as possible.
Secondly - the fight against edema. This is a plaster cast, the exclusion of physical activity, steam rooms, saunas, etc. This is done because during the swelling the skin thickens and the scar is more visible. You also need to ensure that there are no additional injuries and hematomas.

If the scar nevertheless appears (and it manifests itself in the form of a small, well-palpable, and sometimes visible thickening, bumps), the doctor can influence it for six months, while it is being formed - to make it smaller, thinner, more accurate. To do this, special injections are made in the scarring area.
With closed rhinoplasty, scarring is easier to control than with open rhinoplasty. And although it is believed that the formation of the scar lasts six months, in fact, rhinoplasty takes a little longer. And if you look at the photos of patients, 8-10 months after the operation, there are still minimal changes.

I hope that this information will be useful to someone, and I did not convey the words of the doctor very clumsily or distortedly.

Of course, there are a lot of examples when the patient is already fine and he has never had any magic injections and he 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 done rhinoplasty, at the beginning I had no idea why it was so necessary to fight edema, I thought it was just so that my nose would quickly acquire its final form, that the edema would pass anyway in six months, and when the doctor gave me the first injection into that very "dangerous" zone at the tip of the nose, I thought it was just a little whim, so that the swelling would pass faster and the nose would take on its beautiful straight look. But when, a month after the operation, I suddenly had a bump on the back of my nose, on the side of the place where the hump used to be, and lift the hollow, 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." Although the doctor reassured me, I was still worried that the lump was not going away. Andrey Ruslanovich almost every month for half a year gave me injections in the tip of the nose, this area worried him more and only two times 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 externally, it was only a little palpable, and then gradually the nose really became denser and she ceased to be noticeable and excite me. The tip is also straighter.

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

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

I want to advise those who are going to do rhinoplasty, trust your face, only to the most experienced surgeons!!! After all, removing the hump does not mean making the nose beautiful, it is important that the incision itself during the operation is neat and that there are no complications later. Once you've had your long-awaited surgery, follow the instructions and visit your doctor regularly. Let him finish his job and bring your nose to perfection!

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.

Bone callus after rhinoplasty- These are growths on the outer and inner sides of the skeleton of the nose, caused by damage during the operation. They appear if an osteotomy was performed, and in some cases require additional treatment, up to repeated surgical intervention. Why do such formations arise and what is their function? Can they pass on their own? Are there reliable methods of prevention? The site examines the information and shares its findings:

How and why is callus formed?

Normally, the healing of our nose after damage, incl. surgical, occurs in several stages:

Initially, a fibrocartilaginous skeleton grows on the injured area, the main task of which is to keep the broken bones in the most immobile position. This is the corn, 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 provides reliable fixation of bone fragments: the less mobile they are initially, the faster growth will stop. Outwardly, it may look like bumps and bumps on the bridge of the nose, a sudden hump, asymmetry of the sinuses, etc. - depending on which area there was a surgical injury. In uncomplicated cases, this stage takes 2-4 weeks.
The next step is the formation of the so-called. intermediary callus - it occurs between adjacent parts of damaged bones and gradually fuses them, grows into vessels, thereby ensuring complete healing. From the outside, this process is not visible, its course 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 dissolve almost completely. There are no noticeable deformations of the nose, if 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 traces, and ends with the formation of full-fledged nasal structures that are resistant to external mechanical stress and fractures.

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

The cartilage and bones that were worked on are poorly fixed and are in constant motion - for example, due to an incorrectly applied bandage.
Violation of the surgeon's recommendations by the patient in the early postoperative period: any external influences on the nose, attempts to scratch it under the cast, severe sneezing, active physical activity, etc. lead to displacement of bone fragments that have just begun to grow together and enlargement of the callus.
Traumatic technique of the operation. The more severely the skeletal part of the nose was damaged and the less sparing methods of its reconstruction were used, the higher the chances for complicated healing.
Individual characteristics of the organism. In some people, the tendency to increased growth of cartilage and fibrous tissue is genetically laid down - similar to the tendency to form keloid scars.

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

Can it be removed and how to do it?

As a rule, patients begin to panic 1-2 months after the operation, when, firstly, the corn reaches its maximum size, and secondly, the main edema disappears and you can begin to examine your new nose in all its details. But if the surgeon does not see any “crime” during routine examinations (for example, excessively active growth of bone tissue), then there is nothing to worry about. Any formations formed during the recovery period after a rhinoplasty 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 build-up is growing too intensively - an experienced doctor can easily diagnose such a situation at a face-to-face appointment. In this case, it is better not to delay the treatment in order to do without a second operation in the future. The first step is usually one of the following drugs:

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

In addition, physiotherapy can be prescribed: ultrasonic treatment of the problem area with the use of steroid ointment, etc. - such procedures also reduce the severity of inflammation and the size of the emerging callus.

A follow-up examination is carried out ~1 year after the operation. By this time, any growths on the outside of the nose should be gone. 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 a 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 option, pending surgery or if there are contraindications to it.
The main way to remove the old callus is a second operation, which consists in the mechanical removal of the growth. It is performed under general anesthesia, but is otherwise considered much easier and safer than primary rhinoplasty. The bone-cartilaginous skeleton of the nose is practically not injured, respectively, the risk of recurrence is reduced to zero.

Hypertrophy of fibrocartilaginous tissue after rhinoplasty can be prevented. Much depends on the surgeon - during the operation, he must make accurate, low-traumatic incisions, and then correctly combine and fix the bone fragments, providing them with complete immobility. Therefore, the choice of a specialist and his qualifications should be taken very responsibly.

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

in the first three days, observe bed rest;
in no case should you independently remove or loosen it, climb under it with your hands or foreign objects to scratch, etc.;
within 7-14 days after the operation, minimize physical and emotional activity: do not go to the gym, take a vacation from work;
in the first two weeks, clean your nose exclusively with cotton swabs or turundas - it is strictly forbidden to blow your nose;
do not expose your face to frequent and prolonged exposure to high temperatures: a bath, a beach, a sauna, a bathroom are banned for you for a month;
protect the area of the postoperative wound 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 the formation of a problem - and when a person forgets about the operation, he suddenly has breathing problems or his nose “moves out” to one side. Moreover, these complications occur most often, and in about 15% of cases, another operation is necessary to correct the nose.

There are practically no infections, and psychological disorders and complications that appear immediately after the operation share the second place. All of them require urgent intervention of a doctor of the appropriate profile.

In addition to severe complications, there are minor health problems that are 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 the attending physician. Non-compliance with the regimen, refusal to use medications, physical actions that can damage the nose - all this leads the patient to the need for another operation.
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 choose the desired shape and coordinate it with the doctor. This stage 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 technology allows this.

Effects

Doctors distinguish several main types of problems that a patient who has undergone rhinoplasty may face:

Aesthetic. If there is no threat to the health and life of the patient, but, nevertheless, something went wrong, this refers to the aesthetic side of the issue. If the nose after rhinoplasty has become larger, or a hump remains after the operation, the problem is definitely aesthetic.
Functional. Sometimes they are confused with aesthetic because they do not look very attractive. But there is a difference: with functional problems, a person cannot breathe through his nose or experiences certain difficulties in identifying odors.
Infectious. Redness of varying severity, swelling. They are not so common, but may be accompanied by high fever and a 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. Associated with the individual characteristics of the patient's body and can not always be predicted.

If we talk about serious consequences that can harm the health of the patient, the following situations should be distinguished:

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

In the first case, after the operation, there is a high probability of scarring and adhesions, the elimination of which will require additional surgical intervention after the nose has healed. Secondly, the nose may move or deviate to the side, corrective surgery is usually required more often.

In the third, the problem is stopped with the help of medicines and cotton swabs.

Early consequences

Unsuccessful rhinoplasty can lead to the following consequences, which are noticeable within a few hours after the procedure.

Divergence of seams

It appears if the incision was made poorly, or if the surgeon used poor-quality material for suturing. Sometimes discrepancy happens spontaneously, regardless of the quality of the material.

The main thing is to tell the attending physician about the discomfort in time so that he can adjust the course of treatment and send him for a second operation. If you postpone it "for later", but there is a high probability of nose deformity or the appearance of unhealed scars.

Hematomas

Hematoma after rhinoplasty is absolutely normal. During the correction of the nose, incisions are made, in especially complex operations, bones are crushed - damage is inevitable.

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 the nose.

The skins cannot be torn off! They should peel off on their own.

Blue streaks or bruising

Blue stripes after rhinoplasty (especially after complex operations) are due to the ingress of a small amount of blood under the skin. If they do not grow and more bruises do not appear, you need to wait until they pass on their own, if the skin is very tender, the bruises can last for more than a month.

Runny nose

Runny nose does not appear so often and passes quite quickly. Under no circumstances should you be smacked.

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

Numbness

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

Often the sensitivity returns, you have to wait a few days. If numbness occurs a few months after the operation or does not go away even after discharge, it is necessary to consult a doctor again.

Gorbinka

A hump after rhinoplasty may appear due to callus, edema, or a doctor's mistake. In any case, the algorithm of actions is simple: if the swelling has subsided, but the hump remains, you need to wait until the doctor allows the operation again.

Difficulty breathing

To restore the functions of the nose, it is necessary to ask the surgeon to prescribe certain drugs or, if the swelling does not go away, to conduct an additional examination and operation.

Infection

If the disinfection of the room, instruments or the operated area was insufficient, infection can enter the sutures. To exclude this possibility, it is recommended to stay under the supervision of a doctor for at least the first few days. This will be helpful: at the first sign of infection, such as fever, the doctor will prescribe antibiotics.

Necrosis

If during the operation the surgeon made a mistake or something unforeseen happened, because of which blood stopped 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 between 36 and 38 degrees for the first few days, then everything is fine, but if it rises or lasts for several weeks, you should consider 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 can negotiate with your doctor about prescribing appropriate medications. Self-medication 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. There may be different nostrils.
coracoid deformity of the nose, this is when the nose is very full above the tip, and the tip itself is disproportionate to the rest of the nose and is often bent down.
lowered/ excessively upturned tip of the nose.
shortened tip nose.
saddle deformation. The back of the nose sags approximately in the middle. With a pronounced deformation, the subsidence angle is significant, visible to the naked eye, and the tip of the nose protrudes noticeably. The skin in the place of deformation becomes mobile, without the application of effort it gathers into a fold.

Later consequences

Not all effects appear immediately, some may appear after a few months or a year.

Changing the shape of the nose

During the year of complete rehabilitation, the shape of the nose may change slightly - this is included in the risks of rhinoplasty. Nearly half of all reoperations are due to a coracoid deformity.

Too upturned or downturned tip of the nose can also be a reason for reoperation. The following table lists the main mistakes that can be made and their consequences:

Error	Example	Result
Technical error (not too serious)	Improper placement of grafts	Asymmetry after rhinoplasty or irregularities visible to the naked eye
Deformations left unattended	Deformities of different severity levels	Deformation
Doctor's recommendations ignored	Deformity of the tip of the nose	Coracoidal deformity or drooping tip of the nose
Hypercorrection	bridge of the nose	Nose too short, 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 noticed a corn during the examination, measures must be taken before it grows and begins to cause pain to the patient. With the growth of callus, a hump may appear.

Bumps near the eyes

Specific reaction of the periosteum to damage due to surgery. The only way to fix it is to see a surgeon. It appears not earlier than after a few months.

Nasal congestion

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

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

Edema after tip plasty

Edema after rhinoplasty of the tip of the nose occurs as a result of trauma to the soft tissues. Allocate:

Primary. Occurs during surgery.
Secondary. Puffiness is less pronounced. seen after rhinoplasty.
Residual. Outwardly almost invisible.

Puffiness completely disappears 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 age of the patient, and the physiological characteristics of the body.

Smell

Loss of smell is also a common symptom after rhinoplasty. It goes away on its own as soon as the swelling subsides.

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 suggests that postoperative complications have begun and the patient needs medical attention.

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

A putrid smell can be noticeable to others. To prevent the appearance of such a symptom, you should follow the recommendations of a specialist during the rehabilitation period.

Then you need a doctor's help

Bruises usually resolve very quickly, but some complications should be dealt with by a high-level specialist, preferably an experienced surgeon. His assistance should consist not only in laying cotton swabs and prescribing tablets, but also in a second consultation, and, if necessary, surgical intervention.

List of the main complications after which a second operation is inevitable:

Abscess.
Atrophy cartilage.
Impaired function breathing.
intracranial complications after rhinoplasty.
Perforation partitions.

How to reduce the chance of complications

In order not to get a deformation of the nose after rhinoplasty, you need to carefully consider everything to the smallest detail. You need to choose the best clinic and doctor.

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

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

Good afternoon! Tell me, is it normal if I have a low temperature for several days after rhinoplasty? I was not warned about this in the hospital!

Hello! A slight increase in temperature after surgery is normal. Usually, in the first two or three days after the operation, the temperature is kept 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 previous shape of the nose 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 only allows you to visually improve the shape of the nose, reduce it or change the shape of the nostrils. ENT surgery will help change the bone.

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

How long does it take for the nose to heal after plastic surgery?

After surgery, bruising and swelling are observed, which may spread to the eye area or other parts of the face. Puffiness disappears in 7-10 days. At this time, physical activity, exercise is not recommended. Immediately after the operation, bleeding (from the nose) may occur, but these are only the consequences of soft tissue trauma. Bandages, as well as splints, are removed 14 days after the operation, during this period tampons are removed. Some patients feel severe pain when removing tampons, so pain medication is often used. Within a month, mucosal edema can be observed, so breathing will be difficult. After the swelling subsides, breathing will be restored. On average, the result after surgery can be assessed after 6 to 8 months. In rare cases, the result of the operation is evaluated 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 it affect breathing?? Thanks for your reply Alevtina.

Hello Alevtina! Rhinoplasty can help solve your problem. We can enlarge the nose, keeping its shape or changing it according to your desire. Come to us for a consultation and we will discuss the expected results of the operation. Rhinoplasty will not disturb 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 the asymmetry of the face (due to a severely curved nose to the right) with rhinoplasty? Thanks for your reply, Alexey.

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

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

Hello, Maxim Alexandrovich! My daughter has a very big nose, she suffers a lot because of it. Is it possible to have rhinoplasty at 15? How will the operation differ 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 being completed, and this process must be fully completed before the moment when surgery occurs. Try to work with a psychologist, and then come for a consultation when your daughter reaches 18 years old.

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 take? Sincerely, Evgenia.

Hello Evgenia! Yes, it is possible to carry out both operations at the same time. Only in rare cases, two stages are assigned, which are held at intervals of one month. The postoperative period takes about two weeks, during which time bruises and swelling should go away. The 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, then I can not do rhinoplasty? Thanks in advance.

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

Hello Galina! There are two types of rhinoplasty: open and closed. In the first case, a barely noticeable mark may remain on the partition, but with proper care, they disappear after a while. In the second case, all manipulations are carried out without violating the integrity of the skin. What kind of rhinoplasty is appropriate in a particular case - only the plastic surgeon decides after familiarizing himself with the analyzes and examination.

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

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 surgical intervention is such a reaction of the body to injury.

Callus is the result of regenerative processes, its occurrence occurs due to the natural restoration of bone tissue after its destruction.

Do not confuse common callus, for example, on the finger, and bone callus - these are completely different formations.

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

It is important to prevent the appearance of overgrown corns.

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

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

Stages of formation:

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

The timing of the formation depends on such factors:

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

Bone callus is of the following types:

periosteal;
intermediate;
endosteal;
paraossal.

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 forms a small seal along the fracture line. This is the so-called "good" callus, which must appear, otherwise the bones will not grow together.

It acts as a kind of living glue that holds bone fragments together and makes it possible for new bone to grow.

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

Endosteal- is formed from cells of the bone marrow and endosteum, appears next to the bone marrow valve.
paraossal- this is a kind of "bridge" for fragments of bone tissue, it is a soft tissue that is easily destroyed even with not so significant loads.

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

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

Video: Surgical Technique

The reasons

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

The process is as follows:

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

Based on the foregoing, among the reasons for the appearance of callus after rhinoplasty, the following can be distinguished:

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

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

Most often this happens after the removal of the hump on the bridge of the nose and with a complete change in the shape of the nose.

Photo: Before and after the operation

How to remove callus after rhinoplasty

Hypertrophic proliferation of callus can lead to:

hump on the nose, nose deformities;
edema

There are several methods to get rid of callus:

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

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

Also, surgery is indicated in the case of:

high body temperature;
hyperemia, edema.

Preparations

To prevent the appearance of hypertrophied callus, drugs are used that have glucocorticoid hormones in their composition, which remove edema and promote the speedy healing of tissues:

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

Physiotherapy 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 preparations;
ultrasonic exposure using steroid ointment, phonophoresis;
magnetotherapy, UHF;
thermotherapy (thermotherapy).

Prevention

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

strict implementation of the doctor's recommendations during rehabilitation;
urgent appeal to the attending doctor in the event of initial signs and symptoms of the appearance of callus;
the optimal choice of a clinic and an experienced professional for rhinoplasty. The operation is quite common, 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 that you stay in bed for the first 2-3 days - do not ignore this requirement, because this will positively affect your well-being and, ultimately, the result of the operation;
in the postoperative period for at least two weeks, it is better to stay at home, avoid strong physical exertion;
do not blow your nose for the first two weeks (use special sticks to clean your nose);
not less than a month not to visit the beach, sauna, solarium, avoid excessive overheating, exposure to the sun for a long time;
do not engage in strength exercises, do not carry weights for 2 months;
during the rehabilitation period, you do not need to wear glasses (put pressure on the bridge of the nose);
exclude both too cold and hot food and drinks, take food warm.

And yet - do not be afraid of bruising after the operation.

It has been observed that the concentration of a small amount of blood in the osteostomy area as a result gives rise to the formation of a “positive” callus that holds the bones together for 7 to 10 days, and therefore the use of a plaster cast will not be necessary.

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

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