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Steroid Injections for Hard, Swollen Tip After Rhinoplasty?

I had a open Rhinoplasty exactly one year ago. Much of the work was to reduce the tip because it was bulbous. My tip is still hard and swollen. I went to the surgeon for my one year check up, and she gave me a steroid injection. Will this injection actually work to break up the swelling/scar tissue? Should I be taping the nose or massaging it? Isn't one year past the surgery too late for these techniques? Thank you!

Doctor Answers (10)

Steroid Injections for Persistent Swelling after Rhinoplasty

+1

Thank you for the question. Yes, steroid injections (typically kenalog) can be very useful in breaking up hard swelling or scar tissue after rhinoplasty. These can be repeated every 4-6 weeks with increasing doses. Persistent swelling is not uncommon and generally happens at the tip of the nose.  Other treatments, such as massage and taping, can also be helpful. Please stay in touch with your surgeon throughout this process.


Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 37 reviews

Steroid Injections for Hard, Swollen Tip After Rhinoplasty?

+1

Yes.  The steroid injections can help.  I have seen them help even 2 - 4 years after surgery.  Stick with your surgeon.  Sounds like she is on the right track.  Taping will not do anything. Massage after the steroid injections may help.

Stuart H. Bentkover, MD
Boston Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

Steroid Injections for Hard, Swollen Tip After Rhinoplasty?

+1

Steroids are used for hard swollen tips of the nose following rhinoplasty.  They are usually given several months after surgery.  The effect is to have the nose soften and shrink.  After a rhinoplasty the nose can be swollen for a year or more.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
5.0 out of 5 stars 37 reviews

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Steroid Injections After Rhinoplasty

+1

In general, steroid injections especially after a primary rhinoplasty are not indicated. However, in secondary rhinoplasty it may be indicated in a thick-skinned or male patient if done properly, one can do it very judiciously as long as it is not injected in the dermal level. I would highly recommend that it be done by a surgeon of expertise in secondary rhinoplasty. This can be done along with taping and massaging of the nasal tip. It may take up to a year or longer to see the final result in rhinoplasty.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
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Steroid Injections Post Rhinoplasty

+1

In some patients, scar tissue forms underneath the skin envelope which is thick and firm.  This can make the shape of the nose larger and rounder than ideal.  Steroid injections can help break up the scar tissue and give the nose an improved shape when used appropriately.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
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Hard tip of nose and steroid injection

+1

Corticosteroids may help accelerate resolution of swelling due to residual inflammation one year after rhinoplasty, and I know of no other method to accomplish this.  The alternative is just to wait.  There could easily be edema contributing to a large and firm nasal tip one year following your procedure.  If the size of your tip is too large and it is NOT due to swelling, the steroids may not be helpful.  Unless your surgeon recommended it, I would NOT massage or tape.

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 38 reviews

Rhinoplasty and steroids

+1

Steroids injected into the tip may or may not be helpful. Yes, it can reduce residual swelling, but too much may cause soft tissue atrophy and telangiectasias of the skin.  I think you just have to give it some more time and be patient. 

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Steroid injections useful for Rhinoplasty side effects

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The use of steroid injections to reduce scar tissue or certain side effects of Rhinoplasty is quite common, and most specialists have used this technqiue once or more. It is not usually used until most healing has occured (9-12 months or longer). It is effective and your nose will continue to become smaller as each year goes, by not just the first year. This is due to loss of soft tissue volume.

Richard Gentile, MD
Youngstown Facial Plastic Surgeon
4.5 out of 5 stars 19 reviews

Steroid Injections for Nasal Tip Hardness One Year After Rhinoplasty

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Hi Jupiter,

Wait and see how the steroid injection works out. It may soften the firmness. It is possible that you have cartilage grafts in your tip that are contributing to the hardness. Your surgeon best knows what she did at the time of surgery, and is in the best position to answer your questions. Massaging and taping will not help at this point.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Steroid injections will help

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Steroid injections will work to break up swelling and re-channelize the lymphatic edema that occurs in the supratip area of the nose. It does also break up scar tissue. Massaging the nose will not do any good after a rhinoplasty. Blenderm tape used at night and applied across the bridge of the nose for the first 6 months, will help with fluid retention in the supratip area of the nose. Hardness and swelling should start to subside one year past the rhinoplasty. However, depending on the tip techniques and cartilage grafting techniques that were performed on the nose, it could stay swollen for a very long period of time.

William Portuese, MD
Seattle Facial Plastic Surgeon
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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.