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J Cosmet Med 2018; 2(1): 46-51

Published online June 30, 2018

https://doi.org/10.25056/JCM.2018.2.1.46

Nose abscess after thread rhinoplasty: a case report

Al Farabi Lee Jaafar , MD, FPSCS, FPCS, FPSGS

Department of Cosmetic Surgery, Philippine Society for Cosmetic Surgery, Centuria Medical Makati, Makati City, Metro Manila, Philippines

Correspondence to :
Al Farabi Lee Jaafar, E-mail: mail.doctorjaafar@gmail.com, ORCID: https://orcid.org/0000-0002-5553-3301

Received: February 5, 2018; Revised: June 12, 2018; Accepted: June 14, 2018

© Korean Society of Korean Cosmetic Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

A 45-year old female patient developed progressive nose swelling and tenderness after undergoing non-surgical rhinoplasty using polydioxanone threads. Surgical drainage procedure of the nose was done. Intra-operative findings revealed abscess formation over the nasal dorsum extending inferiorly to the nasal tip, supra-septal region and columella. Pus and necrotic materials were evacuated. Culture and sensitivity revealed Propionibacterium acnes sensitive to Ciprofloxacin. Repair of the tip was done with re-approximation of the lower lateral cartilages. The patient recovered with unremarkable post-operative course. Thread use is fast becoming a trend as an option to non-surgical filler and surgical rhinoplasty. Although threads are generally safer than fillers and the technique for insertion is simpler than implant based procedures, surgical aseptic and antiseptic methods should still be strictly applied to prevent the complication of infection.

Keywords: adverse effects, dermal fillers, polydioxanone, surgical wound infection

  1. Khoo BC. Augmentation rhinoplasty in the orientals. Plast Reconstr Surg 1964;34:81-8.
    Pubmed CrossRef
  2. Soo G. Asian rhinoplasty 2 [Internet]. Hongkong: Rhinoplasty Archive, 2011 [cited 2017 Dec 4].
    Available from: https://www.rhinoplastyarchive.com/articles/asian-rhinoplasty-2.
  3. Lafaille P, Benedetto A. Fillers: contraindications, side effects and precautions. J Cutan Aesthet Surg 2010;3:16-9.
    Pubmed KoreaMed CrossRef
  4. Carruthers JD, Fagien S, Rohrich RJ, Weinkle S, Carruthers A. Blindness caused by cosmetic filler injection: a review of cause and therapy. Plast Reconstr Surg 2014;134:1197-201.
    Pubmed CrossRef
  5. Beleznay K, Carruthers JD, Humphrey S, Jones D. Avoiding and treating blindness from fillers: a review of the world literature. Dermatol Surg 2015;41:1097-117.
    Pubmed CrossRef
  6. Chiam CT. The perils of non-surgical rhinoplasty: a safer approach needed? -a comparison between PDO nose threads and fillers [Internet]. Singapore: International Fellowship in Advanced Aesthetic Science (IFAAS), 2017 [cited 2017 Dec 4].
    Available from: https://www.ifaas.co/single-post/2017/01/18/The-Perils-of-Non-surgical-Rhinoplasty-A-Safer-Approach-Needed--Review-of-Applying-PDO-Nose-Thread-Lifting-Compares-to-Fillers.
  7. Ali YH. Two years’ outcome of thread lifting with absorbable barbed PDO threads: Innovative score for objective and subjective assessment. J Cosmet Laser Ther 2018;20:41-9.
    Pubmed CrossRef
  8. Townshend A. Blindness after facial injection. J Clin Aesthet Dermatol 2016;9:E5-7.
    Pubmed KoreaMed
  9. Sarah T. Understanding thread lifting [Internet]. London: Aesthetics Journal, 2015 [cited 2017 Dec 7].
    Available from: https://aestheticsjournal.com/feature/understanding-thread-lifting.
  10. Uniformed Services University of the Health Sciences (USU). Nasal bacteria may be predictor of skin infections [Internet]. Chicago: ScienceDaily, 2014 [cited 2018 Jan 7]. Available from:www.sciencedaily.com/releases/2014/05/140521094318.htm.
  11. Grice EA, Segre JA. The skin microbiome. Nat Rev Microbiol 2011;9:244-53.
    Pubmed KoreaMed CrossRef
  12. Sebben JE. Surgical antiseptics. J Am Acad Dermatol 1983;9:759-65.
    CrossRef
  13. Calfee DP, Farr BM. Comparison of four antiseptic preparations for skin in the prevention of contamination of percutaneously drawn blood cultures: a randomized trial. 2002;40:1660-5.
  14. Rutala WA, Weber DJ, Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for disinfection and sterilization in healthcare facilities. 2008.
  15. McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev 1999;12:147-79.
    Pubmed KoreaMed

Article

Case Report

J Cosmet Med 2018; 2(1): 46-51

Published online June 30, 2018 https://doi.org/10.25056/JCM.2018.2.1.46

Copyright © Korean Society of Korean Cosmetic Surgery.

Nose abscess after thread rhinoplasty: a case report

Al Farabi Lee Jaafar , MD, FPSCS, FPCS, FPSGS

Department of Cosmetic Surgery, Philippine Society for Cosmetic Surgery, Centuria Medical Makati, Makati City, Metro Manila, Philippines

Correspondence to:Al Farabi Lee Jaafar, E-mail: mail.doctorjaafar@gmail.com, ORCID: https://orcid.org/0000-0002-5553-3301

Received: February 5, 2018; Revised: June 12, 2018; Accepted: June 14, 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 45-year old female patient developed progressive nose swelling and tenderness after undergoing non-surgical rhinoplasty using polydioxanone threads. Surgical drainage procedure of the nose was done. Intra-operative findings revealed abscess formation over the nasal dorsum extending inferiorly to the nasal tip, supra-septal region and columella. Pus and necrotic materials were evacuated. Culture and sensitivity revealed Propionibacterium acnes sensitive to Ciprofloxacin. Repair of the tip was done with re-approximation of the lower lateral cartilages. The patient recovered with unremarkable post-operative course. Thread use is fast becoming a trend as an option to non-surgical filler and surgical rhinoplasty. Although threads are generally safer than fillers and the technique for insertion is simpler than implant based procedures, surgical aseptic and antiseptic methods should still be strictly applied to prevent the complication of infection.

Keywords: adverse effects, dermal fillers, polydioxanone, surgical wound infection

References

  1. Khoo BC. Augmentation rhinoplasty in the orientals. Plast Reconstr Surg 1964;34:81-8.
    Pubmed CrossRef
  2. Soo G. Asian rhinoplasty 2 [Internet]. Hongkong: Rhinoplasty Archive, 2011 [cited 2017 Dec 4]. Available from: https://www.rhinoplastyarchive.com/articles/asian-rhinoplasty-2.
  3. Lafaille P, Benedetto A. Fillers: contraindications, side effects and precautions. J Cutan Aesthet Surg 2010;3:16-9.
    Pubmed KoreaMed CrossRef
  4. Carruthers JD, Fagien S, Rohrich RJ, Weinkle S, Carruthers A. Blindness caused by cosmetic filler injection: a review of cause and therapy. Plast Reconstr Surg 2014;134:1197-201.
    Pubmed CrossRef
  5. Beleznay K, Carruthers JD, Humphrey S, Jones D. Avoiding and treating blindness from fillers: a review of the world literature. Dermatol Surg 2015;41:1097-117.
    Pubmed CrossRef
  6. Chiam CT. The perils of non-surgical rhinoplasty: a safer approach needed? -a comparison between PDO nose threads and fillers [Internet]. Singapore: International Fellowship in Advanced Aesthetic Science (IFAAS), 2017 [cited 2017 Dec 4]. Available from: https://www.ifaas.co/single-post/2017/01/18/The-Perils-of-Non-surgical-Rhinoplasty-A-Safer-Approach-Needed--Review-of-Applying-PDO-Nose-Thread-Lifting-Compares-to-Fillers.
  7. Ali YH. Two years’ outcome of thread lifting with absorbable barbed PDO threads: Innovative score for objective and subjective assessment. J Cosmet Laser Ther 2018;20:41-9.
    Pubmed CrossRef
  8. Townshend A. Blindness after facial injection. J Clin Aesthet Dermatol 2016;9:E5-7.
    Pubmed KoreaMed
  9. Sarah T. Understanding thread lifting [Internet]. London: Aesthetics Journal, 2015 [cited 2017 Dec 7]. Available from: https://aestheticsjournal.com/feature/understanding-thread-lifting.
  10. Uniformed Services University of the Health Sciences (USU). Nasal bacteria may be predictor of skin infections [Internet]. Chicago: ScienceDaily, 2014 [cited 2018 Jan 7]. Available from:www.sciencedaily.com/releases/2014/05/140521094318.htm.
  11. Grice EA, Segre JA. The skin microbiome. Nat Rev Microbiol 2011;9:244-53.
    Pubmed KoreaMed CrossRef
  12. Sebben JE. Surgical antiseptics. J Am Acad Dermatol 1983;9:759-65.
    CrossRef
  13. Calfee DP, Farr BM. Comparison of four antiseptic preparations for skin in the prevention of contamination of percutaneously drawn blood cultures: a randomized trial. 2002;40:1660-5.
  14. Rutala WA, Weber DJ, Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for disinfection and sterilization in healthcare facilities. 2008.
  15. McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev 1999;12:147-79.
    Pubmed KoreaMed

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