Rhinoplasty is one of the most popular cosmetic surgeries, but as with any surgical procedure, there are risks of postoperative complications. One of them is fibrosis. If you don't know what it is, keep reading as we will explain what it is, why it occurs, what factors increase the chances of it occurring, if it hurts, and everything else you need to know.
What is fibrosis in rhinoplasty?
Fibrosis in rhinoplasty is a postoperative complication that occurs when the scarring process is excessive, causing thickening of the tissue and the formation of bumps under the skin. This process sometimes alters the aesthetic results of the surgery, generating irregularities in the nose or an asymmetrical appearance.
Most common causes of fibrosis
There is no single cause of fibrosis, but rather different variables come into play for this complication to occur, such as:
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- Prolonged inflammation: Inflammation that does not subside over time prevents the skin from adhering properly to the nasal cartilage, thus promoting fibrosis.
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- Thick, oily or rosacea skin: People with thicker skin or a high production of skin fat tend to have a longer inflammatory process, which increases the possibility of developing fibrosis. People with rosacea (a facial skin condition that causes chronic inflammation, small vessels in the nostrils, and skin redness) tend to be more prone to postoperative fibrosis.
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- Genetic predisposition: Some people have a hereditary tendency to scar excessively or irregularly.
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- Harmful habits: Tobacco and alcohol consumption are important factors that interfere with healing and increase the likelihood of fibrosis forming.
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- Dead spaces: Gaps between the skin and nasal cartilage after surgery can be a direct cause of fibrosis. These gaps prevent the skin from fitting properly, which facilitates the build-up of scar tissue. It is important that your surgeon manages the gaps so that this does not occur and closes them properly.
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- Postoperative infections: Infections delay the healing process, causing prolonged inflammation.
How do I know if I have fibrosis? Main symptoms
Fibrosis does not appear suddenly, but rather gradually. Therefore, it is very common for it to be diagnosed relatively late, especially if the patient does not have enough postoperative check-ups scheduled or does not attend these appointments. In general, the symptoms that indicate the possible presence of fibrosis are:
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- Tissue thickening: The skin on your nose may feel thicker and stiffer to the touch.
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- Bumps or lumps: It is common for small bumps or raised areas to form on the skin.
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- Prolonged inflammation: If inflammation persists beyond normal recovery times.
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- Nasal asymmetry: Changes in the symmetry of the nose.
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- Breathing difficulty: Difficulty breathing, even if mild, or discomfort when breathing, which does not make breathing difficult as such.
Factors contributing to its appearance
Just as there are several causes of fibrosis in rhinoplasty, there are also many factors that increase the possibility of fibrosis appearing. Some factors that contribute to fibrosis appearing are:
Surgical technique used
The surgeon's approach and degree of precision in performing the procedure make a considerable difference. Incorrect handling of the tissues or excessive manipulation of the nasal structures can induce an abnormal scar response. It is essential that the surgeon adapts his surgical technique to each particular case taking into account the characteristics of each patient's skin. If he always performs the same operation, there will be problems.
Inadequate recovery
Postoperative instructions are essential for proper healing. Failure to properly follow medical instructions, such as the use of splints, rest or management of inflammation, facilitates the development of fibrosis. At our center we will give you precise instructions on what to do at all times.
patient age
The ability to regenerate and heal varies with age. Younger patients are likely to have a faster inflammatory response, while in older people, healing tends to be slower, making them more likely to be prone to complications such as fibrosis.
Sun exposure times
Exposing the treated area to the sun prematurely or for a prolonged period negatively affects the healing process, increasing inflammation and the risk of fibrosis due to overproduction of collagen. In addition, it is not recommended as it can cause scars to become pigmented.
pre-existing medical conditions
Systemic diseases such as diabetes or previous immunological disorders can interfere with the tissue repair process, promoting the formation of fibrosis.
When does fibrosis appear after rhinoplasty?
As we have already said, fibrosis does not appear immediately after rhinoplasty, but generally begins to develop as the healing process progresses. Generally speaking, it begins to manifest itself between the first weeks and months after surgery and reaches its maximum expression one year after surgery. In most cases, it is observed that the scar tissue begins to become more evident as the initial inflammation decreases and the skin tries to accommodate itself over the nasal structures.
It is important to note that fibrosis is a progressive process. This means that it will probably not be noticeable right away. During postoperative consultations, surgeons are usually on the lookout for early signs of fibrosis, so that they can act quickly with treatments such as corticosteroid injections to minimize its progression. This is why it is important to attend each postoperative follow-up appointment.
Is it painful? Is it noticeable?
Postoperative fibrosis is not usually painful in itself, although it may cause some discomfort due to the hardening of the scar tissue. Although some people may experience slight tightness or stiffness, severe pain directly associated with fibrosis is rarely reported.
In terms of appearance, fibrosis is noticeable visually in most cases, as it alters the aesthetic results of rhinoplasty. The most common visual effects are bumps, alterations in the symmetry of the nose and thickening of the skin.
Photos of fibrosis on the nose
Do you want to know what a case of nose fibrosis would look like? Here is an example:
How to avoid fibrosis after rhinoplasty? 5 Recommendations
Preventing fibrosis after rhinoplasty depends not only on the surgeon and his surgical technique, but also on the patient and the postoperative care he follows. That is why we leave you here five key recommendations to minimize the risk of developing it:
Apply local cold
In the first few days after surgery, it is essential to apply cold to the nasal area to reduce inflammation. Remember that prolonged inflammation encourages the appearance of fibrosis, so this step is essential.
Perform intranasal showers
Clean your nasal passages with saline solution several times a day, 10 to 12 times, to keep the area free of infections and speed up recovery. Cleansing prevents a lot of complications, not just fibrosis. We also recommend oral and topical antibiotics after rhinoplasty.
Keep the splint in good condition
The nasal splint or bandage is a pillar in the healing process, as it helps the skin to adhere correctly to the cartilage without forming dead spaces. Keeping it clean and well placed will avoid possible complications. It is generally removed after 7 days. Sometimes it is necessary to put on a second splint after those first 7 days, which is worn for 7 more days.
Avoid tobacco and alcohol
These habits directly interfere with healing, because they reduce blood flow and promote inflammation. Quitting smoking and avoiding alcohol consumption 3 months before and in the weeks following surgery will be necessary to prevent fibrosis.
Do not do intense physical exercise
During the first month after rhinoplasty, it is important to avoid any physical activity that may cause pressure or swelling in the nose. Strenuous exercise increases swelling and the chance of fibrous scarring.
What can I do if I have fibrosis? How is it treated?
If you suspect that you have fibrosis, because you have the symptoms and you have recently had surgery in that area, the first thing you should do is consult a specialized surgeon as soon as possible. Fibrosis, although it can be bothersome and alter the aesthetic results of the operation, can be solved if it is treated appropriately. Here we explain the options:
corticosteroid injections
One of the most common treatments to reduce fibrosis is the use of corticosteroid injections. These injections help reduce inflammation and scar tissue buildup, improving the appearance of the nose without the need for additional surgery.
Postoperative follow-up
If you are prone to poor scarring or have thick skin, your surgeon may recommend regular check-ups to monitor the progress of fibrosis and adapt treatments as necessary.
Second rhinoplasty
In more severe cases, when fibrosis is extensive and less invasive treatments are not sufficient, a second rhinoplasty will be necessary. This corrective procedure is performed to remove some of the fibrous tissue and improve the appearance and functionality of the nose. It is important that these types of surgeries are performed by surgeons with extensive experience in secondary rhinoplasty, as they are more complex than the initial surgery. Often, rib grafts will be necessary in these cases.
At Gustavo Sordo Clinic, our team is here to support you. If you are concerned about how your nose is healing or have noticed symptoms of fibrosis, do not hesitate to book your consultation. With over 20 years of experience, Dr. Gustavo Sordo is an expert in advanced rhinoplasty techniques.
So if you are looking for a Ultrasonic rhinoplasty in Madrid, Do not hesitate to contact us.
Conclusion
In conclusion, fibrosis is a complication that can affect the aesthetic result of a rhinoplasty, but with proper postoperative care and regular medical follow-up, it is possible to minimize its effects. Your surgeon should be able to adapt to each skin differently to avoid fibrosis. If you have doubts about your recovery process or are concerned about the appearance of fibrosis, it is essential that you consult a specialist.
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