Supratip revision question. Is this scar tissue? (Photo)

Question

I am 10 months post op and I noticed 2 months ago that my tip has changed! My doctor said it looks like scar tissue and to check back in 6 months!?! How is recovery after a revision? Will the swelling be worse than my first operation? My nose was so nice months ago and now it's like my old nose is back :( I was thinking of getting a revision earlier than 6 months because my job starts at that time, if it's the same in 3-4 months is that a okay time for revision? He doesn't do steroids. Thanks!!!

Kevin Brenner, MD, FACS · Answer

Supratip Fullness following rhinoplasty can be caused be various things. Most commonly, it results from inadequate reduction of the septal cartilage in the supratip area. This usually does not manifest until the swelling starts to resolve from the initial surgery. Other causes can be excessive inflammation with scar tissue deposition in that area, or deprojection of the tip due to a columellar strut graft that is either too short, or possible fractured (I have seen this happen when patients are accidentally hit in the nose early after surgery. No matter the cause, 3-4 months is not a good time to open up the nose for a revision.

Aric K. Park, MD · Answer

Scar tissue takes up to a year to mature. I would see your surgeon for a repeat evaluation as perhaps he could give you a dose of steroid or 5 FU if there is significant swelling. The alternative is that you have some tip ptosis. A common problem after endonasal rhinoplasty is that the tip falls slightly 6 months after surgery, coming a few millimeters closer into the face. This makes the cartilaginous part of the bridge above it appear higher and your nose profile somewhat rounded as opposed to straight. This is easily fixed with a small revision surgery. Your primary surgeon can evaluate you for this and discuss your options.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Supratip fullness can be secondary to:1)scar tissue2)residual fat under your skin3)a prominent cartilaginous septum.In order to provide you a treatment recommendation, you have to diagnose which problem you are having so that it can be corrected appropriately.

Richard W. Fleming, MD (retired) · Answer

There are multiple possible causes of a pollybeak deformity including scar tissue, inadequate tip projection, or an overprojecting septal cartilage. The etiology of your problem can be diagnosed at the time of physical examination to determine what revision will be necessary. Discuss this with your surgeon or consult with a revision specialist.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed and taught Rhinoplasty for 30 years.  If the supratip area is becoming fuller and wider, this is scar tissue development.  This is the main reason kenalog injections are used during the post op healing phase.  The 6 month minimum between Rhinoplasty surgeries is to allow adequate time for the nasal skin to heal and for blood supply to be re-established to the area.  Hope this helps.

Supratip revision question. Is this scar tissue? (Photo)

Answers (5)

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