How Many Kenalog Injections Are Ideal After Rhinoplasty?

I had my first rhinoplasty last year and the doctor gave me a kenalog injection a week post-op and another 5 months later, but scar tissue started to form 2-3 months post-op. I had a revision last week to have scar tissue removed and my doctor just gave me an injection. Should I ask for another injection? I want to do anything I can to prevent excess scar tissue from forming again. How many injections do doctors that use kenalog usually give their patients after surgery and when?

Doctor Answers 15

Kenalog injections after rhinoplasty

Hi,

There is no standard number of Kenalog injections that one should have following surgery. It really depends on how your body responds to the injections. Most surgeons use as many injections as is necessary to achieve an adequate result or until there is no further progress.  This could be just one injection or several injections. Most surgeons space the injections over the course of several weeks (4-6 weeks) in between injections. Good luck with your healing.

Dr.Sunder

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How many steroid injections are ideal after rhinoplasty?

Swelling after rhinoplasty particularly in the nasal tip is normal and is a part of normal healing. There is little to stop the tip of your nose swelling as only a small volume of swelling can be visible in this area of the nose.
A combination of factors will help with reducing swelling. Firstly, sleeping with your head slightly elevated above the rest of your body. Secondly, the use of taping compression of your nose soon after surgery. Thirdly, the use of anti-inflammatory treatments to the tip of the nose, including steroids. Dr. De Silva advocates the use of such medicine in most patients to speed up the resolution of swelling and ensure faster recovery after surgery. Although the final results of rhinoplasty can be more than one year after surgery, the use of anti-inflammatories can shorten this period considerably. Patients with thicker skin which includes certain ethnicities and ethnic rhinoplasty, may benefit from more than one anti-inflammatory treatment. As with every medication there is always a small risk of side effects and anti-inflammatory medications are not suitable for every patient. There is no optimal number of treatments, as the number of steroid injections should be tailored to your individual needs some patients may need no treatments at all, some may require a course of steroid treatments to give the best final result. 

Kenalog injection after rhinoplasty

Steroid injections after rhinoplasty are not required in the majority of cases. Swelling is a normal phenomenon following rhinoplasty and resolves over time.

Steroid injections following rhinoplasty are indicated when there has been excessive scar tissue production deep to the skin - this manifests itself by the appearance of swelling. This is most commonly in the supratip (area just above the tip) or tip regions. Steroid injections typically take about 2-3 weeks to start to work. They should be used judiciously as when too much is injected or injections are performed to frequently, they can cause excessive thinning of the skin and contour irregularities, or loss of pigmentation that can take a long time to resolve. If further injections are required, they are typically done at least 6 weeks after the previous injection. Steroid injections can be quite unpredictable-sometimes they can appear to have minimal or no effect and in other cases they can lead to the dramatic side-effects that I mentioned previously. Ideally, the fewer injections that are required, the better. It is better to be more conservative using steroid injections following rhinoplasty than be too aggressive.

Steroid injections after rhinoplasty

The ideal number is zero but if it is necessary, I never give more than 2 injections, 6 weeks apart.

The Best Time and Ideal Number of Kenalog Injections After Rhinoplasty

Hi Looking,

The ideal number of Kenalog injections after rhinoplasty is 0.  Kenalog can be injected after rhinoplasty in hopes of decreasing swelling and the formation of scar tissue.  There is no ideal time or number of injections.  The timing and frequency of Kenalog injections should be determined by your surgeon, assuming that your surgeon is skilled and experienced in rhinoplasty.  I hope that your nose heals well.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

You should follow your Rhinoplasty surgeon's recommendations

You should follow your Rhinoplasty surgeons recommendations as you are still under his/her care in the acute post op phase of your Revision Rhinoplasty.  Now, IMHO, is not the time to go go doc shopping for other advice or recommendations as no one here has any knowledge of what was done to your nose during these two Rhinoplasties and as such should not offer any advice.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Kenalog cannot make a result good by itself

My basic rule for myself is that it is my job to get the nose just right--that means good tip shape and support.  If I have done so, Kenalog is never necessary.  Kenalog can reduce temporary swelling but cannot make inadequate tip shape into good tip shape.  That is the job of the cartilages, and therefore the surgeon.

Wait for your healing.  "Scar  tissue" may not be the cause of your tip shape; it may be not enough, or not well-shaped, tip cartilages.  If so, you should see an experienced surgeon whom you trust and who can demonstrate in photos of patients with similar problems that he or she can fix your nasal tip.

Good luck.

Mark B. Constantian, MD, FACS
Nashua Plastic Surgeon
4.5 out of 5 stars 23 reviews

Kenalog after rhinoplasty

There is no hard rule to how many and how often. I also will inject after the first week in patients who I think have thick skin and are at high risk for scar tissue to form and blunt the result. I'll repeat it at 3-4 weeks if I still think that there is swelling that will respond to it.  In ocasional patients I may repeat it again at 3 months but this is not routine for me. Other surgeons have their own routine based on their experience. Some may never do it. Regardless the decision has to be based on what your surgeon thinks is best in your case, not how often others do it.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

How Many Kenalog Injections Are Ideal After Rhinoplasty?

It is best to have Kenalog injection early post operative period when scar is forming to prevent its formation. Your surgeon is the best person to decide when is the right time to have this done.

Mohsen Tavoussi, MD, DO
Huntington Beach Facial Plastic Surgeon
4.5 out of 5 stars 7 reviews

Kennalog after rhinoplasy

Unfortunately, steroid injections do not always work. When they seem to improve scar formation,I inject every two weeks until no further improvement  is seen.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.