Scar tissue or swelling 2 years later... will this ever go?

Swelling versus scar tissue: there are three factors that contribute to the appearance of the supratip area in the postop period. These include swelling, which is fluid accumulation in the tissue post trauma, scar issue which is our bodies glue to heal surgically cut tissues, and the thickness of the skin to start with. Swelling is most prevalent in the early postoperative timeframe which is the first one to three months. Scar tissue builds up after surgery during the first one to three months and may take one to four or five years to resolve on its own. So as swelling is going down scar tissue is building up. By three months most of the fullness in the tip and supratip areas is due to scar tissue and the inherent thickness of the patients skin and soft tissues. The steroid injections reduce swelling, reduce Scar issue, and atrophy the patient’s own skin and soft tissue. You probably do not have swelling, technically at this point. Most of what the steroid injections are aimed at is dissolving scar tissue, and shrinking or atrophying your own thick soft tissue and skin. In patients with very thick skin this can be a long and frustrating process. But it is better to approach it gradually rather than over shoot. Too much steroid, or injections given to soon after the previous one could cause indentations and irregularities which are difficult to fix. Patients with very thick skin will probably never have a “pointy“ type of tip. Patients with extremely thin skin will sometimes have tips which are too “pointy“ and this is not necessarily a better problem.

Hello @Angels2000, thank you for your question. Is important to review what type of process is being treated. What the patient wants achieved and if there is the possibility of a permanent and surgical solution. It would be important to make an in-person appointment to define if an MRI is required to define the surgical plan. To obtain more information and recommendations, it is best to consult one or more board-certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS.