6 months ago I had a rhinoplasty, and about 2 months into the healing process I developed pollybeak deformity. Last week I had a revision and my dr took out all of the "soft tissue" from the pollybeak. It looked GREAT when I first took the bandages off but now the hump is coming back! Will this resolve by itself, or will I have to wait a year and then get a completely new rhinoplasty? I'm seriously at my wit's end--by the way, steroid injections don't help (tried it last time).
6 Months Post, Developed Polly Beak Deformity. Had Revision Last Week, Hump is Returning? (photo)
Doctor Answers (5)
Too early to tell at if the polly beak is back...
You are very early in the healing phase. I think there are 3 reasons patients get polly beaks:
1. The tip is too weak and drops back making the lower part of the bridge appear too high forming a polly beak, this can be seen immediately after surgery or it can develop slowly as a weak tip drops back over time.
2. The lower part of the bridge right above tip is left too high forming a hard tissue polly beak.
3. Both the lower bridge and the tip are lowered or reduced too much and the skin is loose and in excess and forms a ball or lump of tissue that is a soft tissue polly beak.
Any one these could be the reason you are are developing your issue. Only the surgeon has a good chance of predicting where you will end up when the swelling goes down, which can take months. There are many times that I do a rhinoplasty and I set the tip and bridge where the nose looks nice but there is so much swelling during the recovery period it looks like the patient has a polly beak. Since I did the surgery I know how well I set the tip and what it will look like as the edema goes down.
Unfortunately it is a guess whether your problem will resolve over time. Be patient. Do not doing anything in a rushed manner. In some select cases I will use kenalog above the tip if it seems like there is too much edema, but you have to be careful as these injections can injure the skin.
Talk to your surgeon about your concerns. I am sorry you are going through this the second time around, it can be very frustrating.
1 Week After Polly Beak Revision
Some of this may be due to swelling creating a larger differential than actually exists. Give at least a few months to get a better idea before another revision.
At this time fresh out of surgery it is a waiting game again. It may just be swelling from the surgery.
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This can be a difficult problem. It's better to prevent it inthe first place with a Guyuron supratip stitch or repair of the pitanguy ligament. Now that it is full there again I suggest time and discuss with your doctor taping strategies. Also don't discount steroid shots. They can help when done well.
I first answered the question from my iphone and the supratip deforimity was not as eveident as it is from my home computer. That is dramatic. I almost wonder if you have little blood collected there. I would discuss this with your surgeon.
Edema after Revision Rhinoplasty
Your question is very hard to answer at one week post op. You definitely have swelling, and the short time period between your surgeries will initially make this swelling more pronounced .Cortisone may help to speed up the process when your doctor feels you are ready for that.