Around 5 and a half years ago, I had Rhinoplasty to address my nose tip that was too round. All went well, and after two years, I had a revision to correct the tip even more, for there had been a lot of scar tissue there. The surgeon injected at the end some Kenalog on the bridge and it looked perfect. However, he didn't wanted to inject Kenalog on the tip where there still are a few lumps. Another revision would be too dangerous.
We are now 1.5 years ahead since the last revision, and I wonder, is there anything can be done about this? Is Kenalog an option, or are there new techniques for scar tissue that might be an option? I have consulted two plastic surgeons, and they both gave me different answers.
If you are unhappy with the appearance of your nose specifically of your tip because of some tip irregularities, then I suggest a tip revision would be in order. Fillers like Radiesse to camouflage it may not do the trick. Often it is scar tissue/cartilage that causes the irregularities. Kenalog injections into the tip may thin the skin too much and cause telangiectasias to sprout.
As a plastic surgeon, who performs many revisional rhinoplasties, I am often faced with people like yourself. The first thing to consider is the level of swelling and scar tissue. it is not unheard of to see swelling and hard scar tissue continue to resolve even three years after the surgery. Once the tissue is soft, better evaluation can be done and the chance of a succesful outcome is improved. Secondly, the more procedures you have, the lower the expectations must be. The reason you are having additional surgeries must in part be the result of your own healing tendencies. Further surgeries do not alter your own tendencies to scar and swell. Finally, the outcome of tip surgery will depend on that which was done before me. This means that the integrity of the existing tip will determine the extent of surgery to be performed.
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