question-icon

What causes severe swelling in face and pus filled eyes after a rhinoplasty?

default
Posted on Sat, 14 May 2016
Question: Hello,
I'm 3 weeks post-op from a rhinoplasty to correct a septum perforation and ear graft to build a bridge. By Day 2 after surgery, my face was so swollen I was unrecognizable. Eyes swollen shut and full of puss. After reaching out to Dr. and on call Nurses, they all said swelling is normal. Finally, my wife brought me to the ER where they started me on a 10-day antibiotic without doing a culture. Anyways, at my follow up with the assisting surgeon yesterday I was informed that I have E. Coli and Klebsiella in my nose. Any idea how this happened? I read that they are both resistant to antibiotics. Also, the septal repair was unsuccessful from all the infections. Just looking for insight.


I attached 2 photos. The first is at day 2 after procedure. Everyone kept saying I was fine, but we knew not. The second is me today, with a 20 degree upturn that I did not want. I don't look anything like me. I didn't go for cosmetic surgery, it was to repair what I had left of a septum.
doctor
Answered by Dr. Hariom Sharma (4 hours later)
Brief Answer:
Better to consult with your operating doctor

Detailed Answer:
Hi Mam,
Welcome to HCM.
I have gone through your query and uploaded images and report.

They suggest that you may be suffering from the cellulitis of your face most probably due to the infection.

In this condition I personally suggest you that you may go for the broad spectrum injectable antibiotic till culture and antibiotic sensitivity test. No need to worry that antibiotic also available for E. coli and Klebsiella. Better to consult with your operating surgeon because on seeing the latest image you are looking fine expect your culture report.

I also have gone through your second image that showing the 20 degree upturn most probably due to the over augmentation of your tip of nose.

You may go for the
1. Antibiotic sensitivity test for selection of antibiotic.
2. Total leukocyte and differential count and ESR for infection.

Regards
Dr Hariom Sharma MS, XXXXXXX

Above answer was peer-reviewed by : Dr. Deepak
doctor
default
Follow up: Dr. Hariom Sharma (10 hours later)
Thank you, Dr. XXXXXXX

Can you tell me how many degrees I can expect my nose to settle down, on average?

Also, how likely is it to get both E. Coli and Klebsiella at the surgical site? Did I get it during surgery?

Thank you.
doctor
Answered by Dr. Hariom Sharma (7 hours later)
Brief Answer:
Not during the surgery

Detailed Answer:
Hi Mam,
I have gone through your follow up query and for your kind information your nose to settle down to near normal i.e. about 10 to 15 degree but it can take as long as a year for the final shape to become apparent.

Most probably infection to the surgical site is not during the surgery but may be post operatively.

Regards
Dr Hariom Sharma MS, XXXXXXX

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
default
Follow up: Dr. Hariom Sharma (4 hours later)
Ok. Thank you
doctor
Answered by Dr. Hariom Sharma (6 hours later)
Brief Answer:
Most welcome

Detailed Answer:
Hi Mam,
You are most welcome.

Regards
Dr Hariom Sharma MS, XXXXXXX
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
Answered by
Dr.
Dr. Hariom Sharma

ENT Specialist

Practicing since :2006

Answered : 1113 Questions

premium_optimized

The User accepted the expert's answer

Share on
What causes severe swelling in face and pus filled eyes after a rhinoplasty?

Brief Answer: Better to consult with your operating doctor Detailed Answer: Hi Mam, Welcome to HCM. I have gone through your query and uploaded images and report. They suggest that you may be suffering from the cellulitis of your face most probably due to the infection. In this condition I personally suggest you that you may go for the broad spectrum injectable antibiotic till culture and antibiotic sensitivity test. No need to worry that antibiotic also available for E. coli and Klebsiella. Better to consult with your operating surgeon because on seeing the latest image you are looking fine expect your culture report. I also have gone through your second image that showing the 20 degree upturn most probably due to the over augmentation of your tip of nose. You may go for the 1. Antibiotic sensitivity test for selection of antibiotic. 2. Total leukocyte and differential count and ESR for infection. Regards Dr Hariom Sharma MS, XXXXXXX