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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 14

Steroid injection to the nasal tip

Steroid injections help expedite the resolution of swelling and inflammation.  They can also dissuade scar tissue from forming.  When needed, the are usually they are more effective when injected sooner than 1 year out.  You may still have some residual swelling, but it may also simply be how your nose is going to continue to look if it is due to the underlying cartilage framework.  If you are still noticing slow, but steady change, its probably best to see the effect of the injection and give it a little more time.


San Diego Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Use Injections Judiciously

It’s not unusual for patients to experience significant swelling following rhinoplasty surgery. This swelling may persist for 12 to 18 months following surgery and results in the nose being extremely stiff. When this situation arises steroid injections are occasionally helpful. It’s important to use steroids judiciously because they can cause hypopigmentation, spider veins and skin atrophy.
Swelling usually resolves with the passage of time. For this reason, patients considering steroid injections should consider the pros and cons of this maneuver before proceeding.

Do I need steroid injection 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. Dr. De Silva routinely uses steroids with other anti-inflammatory medications to speed up the resolution after surgery as part of the procedure to give every patient the best possible result.

Hard nasal tip

Yes, a steroid injection in your nasal tipis an excellent way to make the tissue soften and the skin thin out a bit.  I use this techniques commonly.  The improvement will be quite gradual, ver a few months, but it is commonly used in cases like yours.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

Steroid Injections for Persistent Swelling after Rhinoplasty

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.

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Steroid Injections for Hard, Swollen Tip After Rhinoplasty?

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 20 reviews

Steroid Injections for Hard, Swollen Tip After Rhinoplasty?

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 56 reviews

Steroid Injections After Rhinoplasty

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
5.0 out of 5 stars 25 reviews

Steroid Injections Post Rhinoplasty

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
5.0 out of 5 stars 93 reviews

Rhinoplasty and steroids

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 19 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.