I had my third rhinoplasty about nine months ago to remove fatty tissue on the right side supratip region and push the right bone in towards the center to make the nose straight. Immediately after the cast was removed, the nose looked absolutely perfect, but a couple days later there was severe swelling where the tissue was removed from. Since then, the nose has appeared to be swollen there. Can kenalog help at this stage? How likely is it that the nose will heal further?
Swelling at Supratip 9 Months Post-Third Rhinoplasty? (photo)
Doctor Answers (5)
Swelling 9 months after revision rhinoplasty
In general, swelling can be influenced by the following: Whether the procedure was a revision, whether the procedure was open or closed, whether any tip work was performed, and the thickness of the patient's skin. It is not abnormal to still have swelling after 9 months. The final result of rhinoplasty is not typically evident for 18-24 months following surgery. In this situation, a little bit of Kenalog mixed with 5-Flourouracil may help. I would recommend speaking with your surgeon about this option and see what he/she advises. I hope this helps, and I wish you the best of luck.
Web reference: http://www.spaldingplasticsurgery.com/face/rhinoplasty/
Reducing swelling of your nasal tip after Rhinoplasty. What helps?
After rhinoplasty, advice is given to patients to avoid strenuous activity for the next 3-weeks and patients should place ice over the bridge of their nose 10 minutes every hour for the first two days, these instructions are important to follow as they do reduce swelling. During the first week the cast over the bridge of your nose limits swelling and often there is an increase in swelling after cast removal. Meticulous surgical technique including cartilage suturing and electrocautery is also important to minimise post-operative swelling. Approximately 80-90% of the swelling will have dissipated over the first week, however in revision rhinoplasty the swelling can be more pronounced and last for longer. I often uses anti-inflammatory medications in the recovery period to enhance and speed up the resolution of swelling. The final result from surgery is usually apparent at 1-year, using such agents to reduce tip swelling in a shorter period. Patients who undergo revision rhinoplasty and of certain ethnicity may have swelling that takes a longer period to resolve, in such noses the use of anti-inflammatory injections into the nasal tip helps to reduce swelling and speed up recovery.
Swelling at Supratip 9 Months Post-Third Rhinoplasty?
Perhaps, Kenalog injected inpto that area could be useful at 9 months post Revision Rhinoplasty. In revision cases, the post Rhinoplasty swelling can persist for 18 months or longer, so kenalog to decrease the swelling and scar formation might be considered. I'd use the more dilute kenalog 10, not the 40 in a small amount and then see what happens. Over-injection can cause indentations that may be permanent.
Web reference: http://www.drfpalmer.com/Rhinoplasty.html
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At nine months, most of the nasal swelling should go away. I am not a big fan of steroid injections, because there are sequela to using steroids.
can never give out direct med advice via internet
but hypothetically if i were treating a patient like you who had a rhino by another doc and came in with a complaint of supratip swelling still present at 9 months i would consider kenelog.
my typical is:
kenelog 40 mixed 50/50 with 1% lido plain
use one cc syringe and 30 gage 3/4inch needle
inject 0.1 to 0.2 cc per area necessary
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