Incidence and Predisposing Factors of Postoperative Infection after Rhinoplasty: A Single Surgeon's 16-Year Experience with 2630 Cases in an East Asian Population

Tran KN, Jang YJ.

What this paper says

Across 2,630 rhinoplasties by one surgeon, infection occurred in 0.84 percent overall but 3.63 percent of revision cases against 0.19 percent of first time cases, a nineteen fold difference.

Overview

The study evaluated the incidence and clinical features of infection after rhinoplasty, retrospectively reviewing 2,630 East Asian cases by a single surgeon from July 2003 to June 2018. Infection rates were compared between first time and revision cases and analysed by materials used, organisms cultured and timing.

Sections of note

Retrospective review of 2,630 cases; therapeutic level of evidence IV.
There were 2,134 primary and 496 revision cases; median age 31 years.
Materials were the patient's own rib in 413 cases, ear cartilage in 572, donor fascia lata in 829, donor rib in 102, Gore-Tex in 373 and silicone in 32.
Twenty two infections occurred, 0.84 percent, of which 18 followed revision surgery.
Revision surgery carried a nineteen fold higher infection rate, 3.63 percent against 0.19 percent.
Women were 3.6 times as likely to develop an infection, P equals 0.002.
The infection rate with the patient's own rib cartilage was 3.39 percent, and with simultaneous septal perforation repair 8.57 percent.
Infection developed within one month in 11 cases, at 12 plus or minus 7 days; MRSA was cultured in eight; 20 cases, 90.9 percent, needed surgical clearance of infected tissue.

What it means for a patient

Infection after a first rhinoplasty was rare, about one case in 526.
After revision surgery the rate rose to roughly one in 28, higher still with rib cartilage or septal perforation repair.
Infection settled at the tip in 45 percent of cases and at the front septum or columella in 32 percent.
Nine in ten infections needed a further operation rather than antibiotics alone.

Why this paper matters

Infection can destroy grafts and force reconstruction, and its true rate after rhinoplasty has rested on small series. This 16 year single surgeon dataset quantifies it and identifies which operations carry the risk. Whether the same rates apply across other surgeons and populations is untested.

Terms

Primary rhinoplasty: a first operation on a nose with no previous surgery.
Revision rhinoplasty: surgery on a nose that has already been operated on.
Septal perforation: a hole through the central partition of the nose.
Fascia lata: a sheet of connective tissue from the thigh, here from a donor.
MRSA: methicillin resistant Staphylococcus aureus, a bacterium resistant to common antibiotics.
Debridement: surgical removal of infected or dead tissue.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“This study evaluated the incidence and clinical characteristics of postoperative infection following rhinoplasty. Methods: This article is a retrospective review of 2630 East Asian rhinoplasty cases performed by a single surgeon (Y.J.J.), from July of 2003 to June of 2018. There were 1595 male patients (69.9 percent)…”

Excerpt; the full abstract is on PubMed.