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Steroid Injections for Decreasing Nose Bridge Height?

asked 3 years ago by tiana36 in los angeles, ca
Latest answer by Pramit Malhotra, MD
Question viewed 5,933 times
Tags: bridge, female, Asian, rib graft, steroid

I am an Asian female, and I had an open revision rhinoplasty using rib graft, done over 6 months ago. I think the level of the bridge is too high. I want to have the bridge lower. Will steroid injections decrease the height of the bridge?

28 answers to Steroid Injections for Decreasing Nose Bridge Height?

+2

Steroid Injection is not Recommended

Hi Tiana, You should consider going back to your surgeon. He can remove the graft and reduce its size and place it back on your nasal bridge. This should be fairly easy and should not cost you much. Please do not use steroid or Kenolog injection as they can thin your skin and make the problem worse. Good Luck, Dr. Sajjadian
Ali Sajjadian, MD

Orange County Plastic Surgeon

www.DrSajjadian.com

+2

Revision rhinoplasty

Dear rhinoplasty patient from Los Angeles, Steroid injection will not resolve the prominence of your nasal bridge. The solution is removal, reshaping of the graft, and then placing back in. Steroids usually help scar and prolonged swelling. Talk to your surgeon, he should be able to do that for you. Good luck and good healing.  
Kevin Sadati, DO

Orange County Facial Plastic Surgeon

www.galleryofcosmeticsurgery.com

+2

Steroid injections

Absolutely not! Steroid injections can lower soft tissue but will have almost no effect on bone or artificial implants, worse the skin may become thinned and weakened over your dorsal implant with disasterous results. If the bridge is not right after implant work you will need some kind of surgical revision.....not steroids
Richard Galitz, MD

Miami Facial Plastic Surgeon
+2

Steroid injections for nasal rib graft after rhinoplasty

Steroids injected into the nose can cause atrophy (shinkage) of the soft tissues of the nose.  It is difficult to control what the final result will be.  There are certain instances where this may be useful (such as a 'pollybeak').  This is not your situation.   It may be that over the next few months, you find that the 'bridge' goes down a bit (as you are only 6 months out).  If this does not work, you may require revision of the graft.   Communicate your... more
Sam Most, MD

Bay Area Facial Plastic Surgeon
+2

Steroids for nasal contour

Thanks for yout question - Steroid injection is not a safe way to correct nasal contour. It is difficult to control the end result and you are likely to have skin hypopigmentation, possible graft infection and tissue atrophy. It would be much better to address the position, shape and size of the graft. This would likely require additional surgery.
Steven H. Williams, MD

San Francisco Plastic Surgeon
+1

Steroids injections are useful for many rhinoplasty patients, but not in this situation

We routinely use steroid injections post-operatively for our rhinoplasty patients. However, we typically do this in the supra tip, nasal tip, or nasal sidewalls. Steroids will not predictably give you the result you want. However, time might be the best solution.
Pramit Malhotra, MD

Ann Arbor Plastic Surgeon
+1

Steroid Injections After Revision Rhinoplasty

In general, it is not a good idea to do steroid injections in revision rhinoplasty except if it is carefully placed in a patient with thick skin in the supratip area and is given early post operatively. One must make sure it is not intradermal, but in the deep subcutaneous tissue in low doses. I would not recommend injecting anywhere else, certainly not to reduce the dorsum of the nose after a revision rhinoplasty. It will only cause skin atrophy, skin discoloration and excess telangiectasia... more
Rod J. Rohrich, MD

Dallas Plastic Surgeon
+1

Rib graft in the Nose

Steroid injections will not reduce the height of a dorsal rib graft whether its bone or cartilage. The best way to address this issue is to remove the graft, re-sculpt it and replace it in the nose in order to lower its dorsal projection
Gary Motykie, MD

Los Angeles Plastic Surgeon
+1

Do Not use steroids to try to lower bridge graft

When you read all the doctors reporting they think it is a bad idea, they must be on to something. I hope this information has been useful to you. Jon I Sattler, MD, Board Certified Plastic Surgeon, Glendora, California
Jon Sattler, MD

Glendora Plastic Surgeon
+1

Steroid and nose height after surgery

The biggest question is do you need a steroid injection to reduce callus which sometimes works or is this not scar tissue at all? If the graft was too dominant and large then no ammount of steriod will work. Sometimes, though, what you may actually be seeing is that the highest part of your nose, near you forehead, is too low giving the pseduoimpression that your bridge is too high. In this instance, the reverse is necessary, and its often that a small ammount... more
Shepherd G. Pryor, MD

Scottsdale Facial Plastic Surgeon

www.valleyfacialplasticsurgery.com

+1

TOO MUCH PROJECTION AFTER RHINOPLASTY WITH GRAFTS REQUIRES A SECONDARY RHINOPLASTY, NOT STEROIDS

I would not recommend a steroid injection to reduce a dorsal nasal rib graft that has too much projection. the best and most definitive way to reduce and shape the rib graft, is to re-sculpt it under direct vision. this will give the most predictable result. get a second opinion if your plastic surgeon insists on the steroid shot to reduce the graft height. Dr. Carlos Cordoba MDCM, CSPQ, FRCS, FACS Plastic & Esthetic Surgeon 4055 Ste-Catherine O.... more
Carlos Cordoba, MD

Montreal Plastic Surgeon
+1

Steriod injection to revise rhinoplasty can be a gamble

If the rhinoplasty has missed the mark, some may suggest steroid to reduce the scar and help reduce the bridge. The problem lies in how much steroid and to what effect. Side effects are thinned skin, blood vessels apparent on the skin, and unpredictable results. The best approach is reduce and shape the cartilage graft directly, with a predictable result. Any shortcut is asking for trouble. Best of luck, peterejohnsonmd
Peter E. Johnson, MD

Chicago Plastic Surgeon
+1

Steroid Injections for Decreasing Nose Bridge Height?

Steroid shots will help only if the height is caused by scar tissue. If the bridge feels hard like bone, then it is probably the rib graft. If this is the case, patience is your best ally as sometimes there is some resorption of the rib graft in the first year and your bridge may end up looking just fine. If not, it may be removed, re-contoured, and replaced.
Anand D. Patel, MD

Austin Facial Plastic Surgeon

www.freshfaceaustin.com

+1

Steroids

No, No, No Steroids are one of those injections that in most instances will not solve anything on a permanent basis, but has the potential of creating more problems-thin skinning, and broken blood vessels. I would avoid it and treat the problem surgically after most of the swelling has subsided.   Dr SIegel
Michel Siegel, MD

Houston Facial Plastic Surgeon

houstonfaces.com

+1

Steroid Injections for Decreasing Nose Bridge Height?

Regarding: "Steroid Injections for Decreasing Nose Bridge Height? I am an Asian female, and I had an open revision rhinoplasty using rib graft, done over 6 months ago. I think the level of the bridge is too high. I want to have the bridge lower. Will steroid injections decrease the height of the bridge?" Corticosteroids are scar and inflammation "killers". They stop all healing / inflammatory responses in the tissues they are injected in and can reduce swelling... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Steroid injections do not decrease nasal rib graft height.

If excessive scar tissue formed on top of your rib graft, judicious steroid injection into this subcutaneous scar tissue COULD help to minimally reduce the unsightly protrusion . . .BUT it is much more likely that the graft is excessively large for your desired nasal appearance, and simply needs removal, reduction, and replacement. I share my colleagues' concerns that steroid injection in the vicinity of a graft is not recommended. Third time revision can be scary for the patient... more
Richard H. Tholen, MD, FACS

Minneapolis Plastic Surgeon
+1

Steriod and nose height

I utilize steroid frequently to reduce callus in rhinoplasty patients after surgery. Callus reduction is very different than reduction of a bone graft. I would not recommend steriod injection onto a graft.
Jay M. Pensler, MD

Chicago Plastic Surgeon

www.plasticsurg.org

+1

At 6 months bridge height will not change much

Rib grafts are often unintentionally over-sized resulting in a high bridge.  The good news is that the graft can be removed, reduced in size, and replaced.
Sam Naficy, MD

Seattle Facial Plastic Surgeon

seattleface.com

+1

Steroid injections will not decrease bridge height

The rib graft done to raise the height of your nasal bridge is what is causing the bridge to be higher than anticipated. Steroid injections along the bridge will not decrease the height of the bridge of your nose. The rib graft will have to be removed in order to restore the lower height to the nasal bridge.
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Injections to the nose after Rhinoplasty

Injections of kenalog and steroid preparations into the superficial aspect of the nose can cause premature atrophy of overlying soft tissue and accentuate bony deformities and cartilage assymetry. Discuss these options with your treating surgeon. A more appropriate therapy would be to inject absorbable or temporary facial fillers such as Restylane or Juvederm. Patients undergoing dorsal bridge adjustment with facial fillers acheive more harmonious nasal profiles.
Raffy Karamanoukian, MD

Los Angeles Plastic Surgeon
+1

No it won't.

Return to your surgeon and have him remove part of the graft lowering the height. Unfortunately, steroid injections will not work and may make it worse. 
Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon
+1

Steroids could make it worse

Steroid injections have a role in many aspects of medicine, but not in your case. I believe that a steroid injection in this area could lead to thinning of the skin, neo-vascularit of the skin (serpentine small blood vessels that form) and possibly even erode the skin. I think an open revision would be my recommendation. Get a couple of opinions from doctors well-versed in revision rhinoplasty with rib grafts.
Francisco Canales, MD

Santa Rosa Plastic Surgeon
+1

Steroid injections to the nasal bridge not a good idea

Steroid injections will be of no benefit and may actually be harmful. This could cause a thinning of the skin of this area along with the formation of spider veins. You should give this area a bit more time. If the rib graft was placed too high as you have stated then it is possible that a surgincal revision is indicated. Your surgeon is in the best position to determine the best course of action.
Jeffrey Zwiren, MD

Atlanta Plastic Surgeon
+1

Revision Rhinoplasty is likely needed

The kenalog injection will only affect your subcutaneous fat, making the skin dented. I would not recommend it. Revision surgery in 6-12 months is the best way to go.
Hisham Seify, MD, PhD

Los Angeles Plastic Surgeon
+1

Will Steroid Injections Decrease Nasal Height 6 Months After Rib Cartilage Grafting?

Hi Tiana, Steroid injections will not significantly reduce the dorsal height of your nose 6 months after rib cartlilage grafting. You should discuss your concerns with your rhinoplasty surgeon and consider a revision surgery in 6 to 12 months if the condition continues to trouble you. Good luck and be well. Dr. P
Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon
+1

Steroids in dilute form will decrease tip swelling

Steroids, if used in a dilute form, will decrease the swelling in the tip if a substantial amount of swelling occurs early after surgery . Placing steroids in the dorsum is not a good idea in my opinion due to thinning of the skin.
John Milam Shamoun, MD FACS

Newport Beach Plastic Surgeon
+1

Steroid injection not really an option for decreasing nose bridge height

Dear Tiana, Steroid injections are used sparingly in order to help settle swelling and occasionally to help prevent scar tissue from being laid down. When the bridge height is too high as a result of a graft- whether it be rib or silicone- steroids will not really help this situation. Since surgery was done 6 months ago there may still be some swelling that is contributing to the height which hopefully will settle down with time. I hope this helps and if you have any other questions for us,... more
Peyman Solieman, MD

Beverly Hills Facial Plastic Surgeon
+1

Avoid steroid injections on nose after Rhinoplasty

If the prominence is due to the rib graft, steroid injection will not help--the bone needs to be rasped lower. Steroid injections can dissolve scar but they also dissolve fat and other tissue and can leave a depression on the nose. If your doctor recommends injection and he is an expert and feels the problem is scar tissue then you will have to trust his judgement--but ask about risk of atrophy.
Brooke R. Seckel, MD

Boston Plastic Surgeon

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