Options for Fixing the Nose Tip That is Too Round?

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.

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21 Doctor Answers | Asked by Jette in Europe

Doctor Answers (21)
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Residual tip lumps after revision rhinoplasty

Residual lumps after rhinoplasty can be due to: Buckled tip cartilage - this may not have been evident until more recently as the skin swelling may have obscured it. Scar tissue - a steroid injection or 5-FU may help this issue if this is causing the problem. It's impossible to give an assessment in your case without examining your nose. There are techniques available to address each concern. The thinner your nasal tip skin the easier it is for underlying... more

Depends on the cause

The lumps are likely deformed cartilage as opposed to scar tissue. Kenalog will not help this situation but a well executed revision rhinoplasty may help.

Sam Naficy, MD

80 reviews

Seattle Facial Plastic Surgeon

www.seattleface.com

Depends on what the lumps are.

There are hundreds of different rhinoplasty tip techniques that can be performed on the nose to make it look better. If diagnosed, scar removal is best performed with Kenalog injections into the tip. This melts scar tissue and removes the lymphatic edema that is trapped in the super tip area of the nose. Injecting Kenalog into the area of the tip where there are some lumps is actually a good idea if these are composed of scar tissue. If the lumps are cartilaginous or bony irregularities... more

Revision Rhinoplasty to address tip abnormalities

At one and a half years out from your last revision surgery, lumps and bumps in your nasal tip are not related to swelling but rather, irregularities of the underlying cartilage. Your best bet would be to consult with a skilled revision rhinoplasty expert who would reshape your tip cartilages to give your nose a more normal appearance. This may require using cartilage from your septum or harvesting a piece of cartilage from your ear. When performed properly, this... more

Kenalog for Nasal Scar

O.K. - Lumps on the tip. 1.5 years after the last surgery. My first thought is cartilage irregularities which would require looking at the tip and correcting whatever deformity is causing the problem. However, after two surgeries and steroid injections into the nose it's really hard to give an accurate assessment without seeing your nose and knowing what your surgeon did. I have actually had good luck with steroid injections into the supratip area of the nose when there is prolonged... more

Revising the nasal tip

Revision of the nasal tip is one of the most challenging aspects of revision surgery. This is not only because of the technical issues, but rather the creation of a suitable surgical plan based on analysis of nasal form. Obviously, we cannot determine this for you in this forum. But, evaluation by an experienced revison rhinoplasty specialist should help determine what is possible for you. Hope this helps, Dr. Sam Most

Sam Most, MD

23 reviews

Bay Area Facial Plastic Surgeon

www.drmost.com

Revision Rhinoplasty

Jette, Injecting the nasal tip with Kenalog can cause thinning of the skin and remaining soft tissue, thus making those lumps more visible. I have found that in revision rhinoplasty cases with visible contour irregularity, certain fillers can be an excellent choice to smooth out these irregularities and sometimes improve the tip shape! It is important to choose a Board Certified Plastic Surgeon when seeking out a rhinoplasty surgeon for these complex secondary nasal shaping procedures. more

You can have nasal surgery without looking abnormal

The goal of surgery is to have a natural nose. In revision surgery you must make sure the surgeon has vast experience since the revision rhinoplasty is one of the most difficult surgeries to learn. Your doctor should tell you his approach to your problem and why he is choosing it. Make sure you see actual photos or patients with your problem and how he corrected them.

Toby Mayer, MD

7 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Kenelog in the tip is generally not good idea, especially if problem is tip bossae.

Jett, The answer to your question partially depends on what the lumps are. For most patients, when they come in and complain of "bumps" at the tip from some other previous surgery, they are talking about tip bossae. Tip bossae occur when surgeons aggressively cut or remove the tip cartilage to make the nasal tip look smaller and more refined. Over time, whatever cartilage is left starts to bend and twist under the weight of the skin. As the cartilage twists on itself, the weak... more

Correction of Nasal Tip Deformity Five Years After Rhinoplasty

Hi Jette, Your question is most difficult to answer without seeing your nose. The most common "lumps" in the tip are bossa caused by the lower lateral nasal cartilage buckling. It is correctable with surgery, but is an advanced technique that should be performed by an experienced and skilled rhinoplastic surgeon. Kenalog injections this far out from your surgery will cause atrophy of nasal tissue, and most likely should be avoided. In the past few years injectable fillers such as... more