I’ve developed internal fibrotic tissue - How to fix this bulbous tip? (Photos)

Question

I’m a 29-year-old male, 6’1” tall and 93 kg. I had a septoplasty two years ago, during which no nasal packing was used. Following the operation, I developed two haematomas around the nasal tip that went undiagnosed for about a week before they were removed. Since then, I’ve developed internal fibrotic tissue within the nasal tip (not on the surface), which has caused persistent swelling and a bulbous appearance. I’m wondering whether Kenalog (triamcinolone) or similar corticosteroid injections could help reduce the internal fibrosis and restore my nasal tip to a more normal size and shape.

Eric M. Joseph, MD · Answer

When somebody gets a septal hematoma, they can sometimes lose bridge support from the nasal septum, and this can give a bit of a saddle nose appearance, similar to what you have. If that's the case. Microdroplet Silikon-1000 injections maybe considered for providing a straight and masculine nasal profile appearance. It is not completely clear that you have a bulbous nasal tip appearance on front view. I hope this helps. Sincerely, Dr Joseph

Guray Yesiladali, MD, FEBOPRAS · Answer

Fibrosis that develops after trauma or a hematoma occurs when the connective tissue beneath the skin becomes thickened and firm.
Steroid injections (such as Kenalog) can sometimes help by reducing collagen production, but:• If the tissue is very dense, the effect may be limited.• For deeper fibrosis, the dose and injection depth must be carefully adjusted.• Excessive dosing carries a risk of skin thinning or indentation.
In some cases, combining injections with gentle manual massage or considering minor surgical revision may provide better results.
If you’d like to understand what might be most effective in your situation, you can have a complimentary discussion with one of our patient coordinators. They can review your history and help arrange a detailed medical evaluation if needed.
Persistent swelling can be discouraging, but careful assessment and the right plan often bring meaningful improvement.
I hope your recovery continues to move in a positive direction and that you find comfort and confidence as healing progresses.
Güray Yeşiladalı, MD

Rafael Ramos Vecchio, MD · Answer

Hello!I hear your concerns. Internal scaring and fibrosis is a real struggle for both patients and surgeons because it can be unpredictable in the long term. Steroid injection can decrease the amount of scar burden but it can be a double edge sword. the same way it thins down the fibrosis, it can spread an thin out adjacent healthy soft tissues or skin. A rhinoplasty surgeon should do a physical exam to determine if the amount of fibrosis and the location is susceptible to treatment with injected steroids or requires a surgical revision. I would not aim to get the steroids from anyone different than a plastic surgeon focused on rhinoplasty or face aesthetics.
Best!
Rafael Ramos Vecchio MDPlastic and Reconstructive SurgeonCoral Gables, FL

I’ve developed internal fibrotic tissue - How to fix this bulbous tip? (Photos)

Answers (3)

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