Steroid for Pollybeak?

Hello, I had a revision rhinoplasty about two years ago, and it was partially to fix a overbearing pollybeak. The surgeon did not perform this service during surgery, though, and since, the pollybeak has become severe (3+ centimeters high). While I believe that part of the pollybeak is indeed cartilage from an severely pinched primary rhinoplasty, I also believe that scar tissue may have also played a role, and if so, could a steroid shot help? Would there be any negatives in trying this?

Doctor Answers (18)

Steroid injection After Rhinoplasty

+2

Hi CSmitty-

Steroid injections to the supra-tip area can help decrease soft tissue inflammation during the healing process up to several months after the surgery. Unless you have very thick skin which can be associated with longer than usual post-operative tip swelling, steroid injections may not be of benefit. Your rhinoplasty surgeon should be able to make this determination.

Sincerely,

Tom Kaniff


Sacramento Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Steroid for pollbeak

+1

This is a safe option and effective - if the pollybeak is soft tissue and scar related and there is good tip support.  Otherwise a revision rhinoplasty with structural grafting would be needed

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 138 reviews

Polybeak

+1

Without examining you fist hand I can only give you general thoughts on the polybeak problem. First this is often a difficult problem caused by a number of factors and often undertreated. A polybeak deformity can arise from simple excess scar tissue in the supratip area that can often be helped with steroid (kenalog shots). After injections of steroids it is important to do mild pressure taping of the area for up to three weeks. However this only works well in the immediate post-operative period not at 2 years out from surgery..... However ,some polybeak deformities arise from bad surgical dynamics and tip ptosis. Oddly enough both too much dorsal excision and too little dorsal excision can both lead to the problem. Too little leaves a high area, and too much causes tip ptosis from lack os support. Columella struts when indicated can lessen the chance of supratip fullness. I personally always put in a strut when I'm doing a correction for supratip fullness. I also use steroids conservatively and persue surgical correction if indicated

Richard Galitz, MD, FACS
Miami Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

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Steroids Not Helpful for Polybeak After Ywo Years

+1

It is not likely that steroids will be helpful for a polybeak deformity after two years.  While very useful in the immediate post-operative period to control swelling and scar, you probably have residual tissue that needs to be rearranged or trimmed.  An experienced plastic surgeon should be able to evaluate your condition and make specific recommendations for you.

Randy J. Buckspan, MD
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Steriods for pollybeak

+1

It is unlikely that after several years steroid injections will help a pollybeak.  Steriods are useful in the immediate post-operative period to reduce swelling and perhaps scar tissue formation, but likely don't have any lasting effect with the progression of time. 

Edward Buckingham, MD
Austin Facial Plastic Surgeon
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Rhinoplasty Revison

+1

Low-dose steroid injections after rhinoplasty can be helpful to reduce postoperative edema and/or early scar tissue formation.  They are most effective within the first 12 months after surgery and/or trauma.  At this point, steroid injection success would be low, but certainly could be done as an intial step before considering further surgery.  It should be noted that steroid injections should be used with caution, because they can produce tissue atrophy if used at larger doses or multiple injections are used.  A careful evaluation by your surgeon, or seeking out a second opinion would be the best first step to determine if the injection(s) would be helpful.  Best wishes.

Michael P. Vincent, MD, FACS

Michael Vincent, MD
Rockville Plastic Surgeon

Steroid Injections for Pollybeak

+1

Physical examination by a rhinoplasty surgeon can determine if steroid injections may be helpful. A pollybeak is caused by an under-projected tip, excess cartilage, and/or scarring above the tip. The fullness is caused by scarring may be improved with steroid injections. Most often, surgery is necessary.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

3+ centimeters?

+1

Steroids do work for pollybeak in some cases. However there are other causes. Your note indicates it is 3+ centimeters high; do you mean millimeters? 1cm=10mm. Post some photos and I will share my opinion. Good luck.

Phillip Langsdon, MD
Germantown Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Steroids for a pollybeak

+1

A polly beak is a high spot on the bridge just above the tip which will make the tip under project. There are many causes of which scar is one of them, though after the nose is fully healed steroids can cause problems with little potential to help the situation. The problem is structural as the tip needs more support, the cartilage portion of the dorsum was left too high, etc. My vote is for a safer revision and a predictable result.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 28 reviews

Steroid injection for pollybeak

+1

I agree with the others, such that you have nothing to lose by trying.  Two years after a revision surgery the nasal structure is probably fairly established, but your only other alternative is a second revision surgery to remove what would then be clearly established as dorsal cartilaginous septum.  You would know within a month, so you are hardly delaying further treatment if you just give it a try.

Kevin Robertson, MD
Madison Facial Plastic Surgeon
4.5 out of 5 stars 8 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.