Why does callus appear after rhinoplasty and how to remove it

Callus after rhinoplasty is formed due to the body's reaction to the changes that occurred as a result of surgery.

During the process of regeneration, new bone tissue grows in place of the removed areas of bone.

A common type of operation, after which a callus occurs in 13 out of 100 cases, is rhinoplasty of the nose.

A callus after rhinoplasty does not pose a threat to the patient’s health, but it deforms the shape and leads to the appearance of humps, irregularities, and asymmetry.

Stages of formation:

• During the first week after rhinoplasty, a provisional callus appears.
• Cartilage or bone tissue is then formed from osteoid tissue.
• Complete formation of callus lasts up to six months.

Types of callus:

• Periosteal,
• Intermediary,
• Endosteal,
• Paraosseous.

Surgeons are interested in only 2 types of formation: periosteal and paraosseous .

• The first type of callus is positive and expected. When it occurs, a thickening of the contours of the nose along the fracture line is observed.
• The second type is unfavorable, since callus develops in the thickness of the surrounding tissues due to the accumulation of bone chips. It is most often formed when hump plastic surgery was performed using a rasp or physiodispenser. Plastic surgeons always strive to prevent such an outcome from the operation.

Radiography helps detect callus : in the pictures it looks like a shell at the site of damage to bone tissue.

Photo

The callus is clearly visible in the photo before and after rhinoplasty.

Causes

The peculiarities of the occurrence of callus lie in the properties of bone tissue, which differs from other organs and systems in the special course of regeneration and restoration processes.

The healing process goes like this:

• Connective tissue forms around the damaged area.
• It forms soft bone tissue from thin fibers.
• These fibers ossify and become stronger. A growth appears at the site of tissue fusion. Its size depends on the severity of the injury received as a result of the operation and the regenerative properties of the patient’s body, which are individual for everyone.

The reasons for the appearance and growth of callus after plastic surgery include the following::

1. The individual ability of the body to restore bone tissue.
2. Experience of a plastic surgeon - after the work of a real professional, hypergrowth of bone fibers does not occur.

More often, the growth of callus after rhinoplasty is observed after removal of the hump and with complete rhinoplasty, when a global correction of the shape of the nose is performed.

What does callus consist of?

Callus has a special structure, which appears as a result of the restoration of bone tissue when it is damaged, and is a natural process. We can say that this neoplasm consists of connective tissue growing at the site of bone fusion.

Bone tissue also grows in three stages:

1. The appearance of a provisional callus;
2. Formation of osteoid tissue;
3. Replacement of connective fibers with bone ones.

Almost always, cartilage tissue is formed first, which eventually turns into bone. This process takes about one year.

How to remove a callus?

Having discovered a callus, people wonder how to remove the complication that has arisen.

Ways to eliminate callus on the nose:

• Repeated surgery (prescribed less frequently than other methods).
• Treatment with drugs.
• Physiotherapy.

In 27% of such cases, repeated surgery will be required to avoid further growth and thickening of the callus.

Callus after rhinoplasty goes away with physical therapy and medication. For an in-depth study of the problem that has arisen and its solution, it is necessary to contact the surgeon under whose supervision the rhinoplasty was performed.

Let's consider each option in more detail.

Operation

Callus removal is carried out when other methods are ineffective, at high temperature, hyperemia and swelling.

Surgery does not guarantee 100% prevention of recurrence of the problem.

Drugs

To prevent the formation of callus after plastic surgery, doctors prescribe medications containing glucocorticoid hormones, which eliminate swelling and accelerate tissue healing.

Use:

• Diprospan - in the form of injections, relieves swelling and inflammation, promotes improved scarring.
• Traumeel S - homeopathy in the form of ointments, tablets and drops, has a complex effect.
• Kenalog – gives an anti-inflammatory effect, used as intramuscular injections.

Physiotherapy

Thanks to physiotherapeutic procedures, the callus gradually resolves.

Methods used:

• Magnetotherapy.
• UHF.
• Thermotherapy.
• Electrophoresis with lidase and hydrocortisone.
• Ultrasound treatment using steroid ointment.
• Phonophoresis.

Physiotherapy methods differ in the duration of treatment.

Bone calluses after rhinoplasty: causes and methods of elimination

Like any other operation, rhinoplasty does not exclude the development of postoperative complications, the nature of which may vary in severity. Complications from an aesthetic point of view include: asymmetry, curvature of the nasal bridge, drooping tip and others. From the functional side, the following are usually noted: difficulty in nasal breathing, perforation of the septum, temporary loss of smell, bleeding, hematomas. Another unpleasant consequence of nose surgery is the occurrence of callus. This is the body's natural reaction to injury. At the site of damage, the process of excessive regeneration of bone tissue begins. Keloid scars have a similar nature. However, this complication does not occur in many patients. What is the reason for the development of callus and whether its occurrence can be prevented will be discussed further.

Statistics of complications after rhinoplasty

One of the complications after rhinoplasty is the appearance of callus - the body’s natural reaction to injury.

Based on the numerous practices of plastic surgery specialists, general complications occur in approximately 1 in 10 people who have undergone surgical correction of the nose, and 1/3 of them require revision rhinoplasty. This number includes operations to remove callus.

What causes the formation of calluses?

To understand this, you should first remember the structural structure of the nose. Its basis is made up of bone and cartilage. During rhinoplasty, surgical removal of these tissues may be required. It is not always necessary for the surgeon to touch the bone to achieve the desired shape, but if this happens, the human body will immediately respond to this.

Bone tissue is specific; it has its own healing characteristics, which, in turn, consists of several stages. The first is the formation of connective tissue around the fracture site - the basis of that very callus. Next, thin fibers of bone tissue appear, then these fibers harden significantly. In the process of replacing connective tissue with bone, the injured area not only grows together, but a growth appears in its place. Even after decades, an experienced specialist can use an X-ray to determine where this fracture was.

Sometimes the surgeon has to remove or grind down bone tissue, in which case a callus is formed without exception. Its extent depends on the depth of the injured bone and nearby tissues, as well as on the individual characteristics of the patient’s recovery.

Valery Staysupov comments:

Plastic surgeon, leading specialist in facial rejuvenation and beauty, surgeon at the plastic surgery department of the SPIC Beauty Institute, specializes in facial plastic surgery, rhinoplasty and breast plastic surgery.

For some reason, out of the many possible complications after rhinoplasty, most girls put calluses in first place. This fact will probably never be answered. Let's start with the fact that callus is necessary. If it is not formed, then the bone tissues of the nose will never grow together. The callus holds the injured tissue together and allows new bone to grow. This formation always forms, so it is stupid to fight it immediately after surgery. The paraosseous type of this complication is extremely undesirable. It leads to the development of callus in the depths of the surrounding tissues. It is precisely this formation of paraosseous callus that surgeons try to avoid during rhinoplasty.

Modern techniques of closed nose correction make it possible to avoid the development of this complication.

I hasten to calm you down! Modern technologies of the closed method of nose correction make it possible to avoid this complication almost 100%.

How to prevent the development of callus?

Callus is not a disease and therefore cannot be treated. However, a set of certain measures related to various procedures, maintaining a healthy lifestyle and taking certain medications can prevent its further growth.

People who have undergone rhinoplasty can be given a number of recommendations that will help reduce the intensity of callus development:

• Maintain bed rest for at least three days;
• Stay at home for two weeks, reduce your work activity;
• Avoid blowing your nose and sneezing if possible;
• Avoid saunas, baths and exposure to direct sun for at least a month;
• Avoid excessive physical activity for two months;
• To speed up the healing process, attend physiotherapeutic procedures.

The surgeon can prescribe several types of therapeutic and physiotherapeutic sessions. If there are indications, the following are usually recommended: magnetic therapy, electrophoresis, UHF, administration of Diprospan. The latter method significantly reduces swelling and inflammation.

Surgical removal of callus

Choosing a competent surgeon will save you from the need for repeated nose correction

Unfortunately, functional and aesthetic complications often require revision rhinoplasty, this also applies to callus.
Planning a secondary rhinoplasty requires particularly careful preparation from the surgeon to eliminate the problem and avoid the regrowth of excess bone tissue. The volume and timing of secondary correction are prescribed depending on the patient’s condition. By responsibly following all the doctor’s recommendations, you can avoid excessive growth of the bone tissue of the nose and the development of other complications. Among the many surgeons, choose only professionals in their field; their experience and knowledge will help you avoid unpleasant postoperative consequences and repeated surgical correction of the nose.

Prevention

Preventive measures against callus formation after rhinoplasty:

• Fulfilling doctor's orders during rehabilitation.
• Urgent contact with an observing specialist when the first signs of pathology appear.
• Careful selection of the clinic and surgeon for the operation. Since rhinoplasty is a common procedure and has an affordable price, it is important to analyze all the offers and choose the most proven one with a good reputation, without being tempted by low prices and dubious reviews.

Diagnosis of the disease

The development of callus can be diagnosed using radiography. In the picture it will be visible as a small shell at the site of tissue damage. Rehabilitation is a fairly long and complex process. Its main goal is to stop the growth of bone tissue.

Callus cannot be called a disease, because there is no treatment for it as such. However, there are many different techniques that can improve the patient’s nutrition, reduce the inflammatory process at the site of injury and prevent further growth of bone tissue.

In order to improve the healing of bone tissue, specialists prescribe the following therapy:

• Physiotherapy;
• Surgery to remove bone tissue;
• Treatment with medications.

Removal of callus is considered a radical method and is carried out only in cases where other therapy has not been effective.

Accelerated rehabilitation

For patients who want to quickly overcome the period of operational inconvenience, our Center provides an accelerated rehabilitation complex.

• Injections of lymphatic drainage drugs The composition of the drugs includes biostimulants, peptides, a complex of microelements and vitamins. They improve blood and lymph circulation and have anti-inflammatory properties. Minimize swelling and hematomas, accelerate wound healing.
• PRP plasma therapy Blood plasma is rich in platelets, which use the body's reserve forces. The work of the immune system is enhanced, regeneration processes proceed faster. Swelling and bruising disappear, soft tissues heal faster.
• Microcurrent therapy Exposure of facial skin to weak currents activates cell function. Recovery processes are accelerated, blood circulation improves. Swelling and pain go away, spasms of the muscles of the face and neck decrease.

Minimizing swelling and bruising, reducing muscle tension is possible on the day of your visit

After restorative procedures, the condition improves instantly. You can lead your usual lifestyle - walking, going to work and visiting. But do not forget to follow postoperative recommendations to avoid complications!

Levin Dmitry Valerievich

Founder and Chief Doctor of the Center

Plastic surgery of the back and tip of the nose without osteotomy

If you want to correct the tip and bridge of your nose, but do not want to make the bridge thinner and the deformation is not pronounced, you will undergo surgery without osteotomy (without surgical dissection of the bone structures). In this case, nose correction will be carried out by influencing the patient’s cartilage.

Correction of the nasal bridge is indicated for patients with a hump, a wide dorsum, or curvature of the dorsum associated with anatomical features or trauma. Often accompanied by correction of the tip of the nose, the wings of the nose, as well as when performing rhinoseptoplasty (correction of the nasal septum).

Often back correction is performed with septoplasty. When the patient experiences difficulty breathing, which is associated, for the most part, not with an aesthetic problem, but with the fact that the curvature of the back is accompanied by problems with the nasal septum. Externally, the nose may “go” a little to the right or left side and cause psychological dissatisfaction with its appearance. In this case, the curved septum does not allow the patient to breathe fully. Lack of oxygen for the body is a serious problem. A person more often suffers from headaches; insufficient oxygen affects all systems of the body, but most importantly, the heart and brain. Correction of the tip of the nose and correction of the wings of the nose can be combined with other manipulations. So, without surgical intervention you can get rid of a whole range of problems.

How is surgery performed in our clinic? When performing rhinoplasty, we use a closed method without osteotomy. We use a unique ultrasound device - a piezo knife (the operation is often called piezorhinoplasty). This method makes it possible to make the operation not only less traumatic, but also a jewelry one. When the surgeon’s work is clear, accurate and coincides with computer modeling up to 95%. This is a very high percentage in rhinoplasty, since the tissues and anatomical features of the patients are different, but the result is always desired and impeccable.

After correction of the nasal bridge, a plaster cast is applied. At the moment, in the usual view, gypsum does not correspond to what it was 10-15 years ago. This is a special flesh-colored pad that fits tightly onto the nose. Wearing a cast is mandatory and lasts from 10 to 14 days; in isolated cases, with complex rhinoplasty and nose reconstruction, the cast can be removed 21-23 days after surgery.

After surgery, it is important to follow all doctor's recommendations. A stable and desired result can only be achieved through joint work between the plastic surgeon and the patient. We are in touch with our patients around the clock, performing the necessary procedures for better healing and reduction of swelling. External swelling goes away within 3-4 weeks, internal swelling can persist for up to several months. The result after surgery should be assessed only after 1 year, but this does not mean that the patient will not see the effect immediately. It is important to understand that tissues and the human body are a complex system and any surgical intervention requires patience. Rhinoplasty is one of the most difficult plastic surgeries. Therefore, trust only professionals and take care of your health.

General recommendations after bone grafting

Following your doctor's recommendations during the rehabilitation period will prevent possible complications. The list is in the medicine package.

General recommendations after bone grafting:

• At first, it is better to refrain from chewing on the operated side.
• For the first 2-3 days it is recommended to eat only crushed food at room temperature
• You should not smoke or drink alcohol for 2 weeks after surgery.
• Do not drink through a straw
• It is recommended to cough gently and with your mouth open so as not to increase the pressure in the mouth.
• Sleep better with the head of the bed raised
• Serious physical activity and diving for several weeks are prohibited
• Prolonged exposure to the sun is not recommended; you should avoid visiting solariums.
• It is prohibited to visit the sauna or bathhouse
• You should avoid flying in the first few weeks after bone grafting.

The patient must maintain physical and emotional rest. The doctor will monitor your condition and monitor you during scheduled visits.