I had an open rhinoplasty about 2 months ago and since the cast was removed my nose shape hasn’t basically changed.My tip feels very hard and when I apply pressure to the area, it doesn’t go down. Is this just swelling or do I have a supratip fullness?My surgeon says that the healing process is ok and the swelling will go down naturally in 6-12 months.If this won’t happen he talked about steroid injections. I’m worried...will these injections be effective after such a long time from the surgery?
September 7, 2014
Answer: Yes, I think this is a mild polly beak deformity. Though this could be swelling, the hardness you describe makes scar fibrosis more likely. It also could be inadequately-resected cartilage. It takes noses a full 6-12 months to completely settle and scar tissue to mature after rhinoplasty, so you have answered your own question about potential steroid effectiveness that long after surgery (but only if it's scar tissue).If you were my patient, I would start steroid injection very gingerly now, using 0.1cc of 10mg.cc triamcinolone and checking effectiveness at 6-8 weeks. Nothing or minimal response is OK, as I can always increase concentration up to 40mg/cc and also increase dosage. But start conservatively, since some patients respond aggressively, and you don't want a dent!I think if you wait until a full year has passed you may have missed a window of (better) opportunity. But that's just my opinion after 27 years of doing cosmetic rhinoplasty. Talk with your surgeon. Best wishes! Dr. Tholen
Helpful 1 person found this helpful
September 7, 2014
Answer: Yes, I think this is a mild polly beak deformity. Though this could be swelling, the hardness you describe makes scar fibrosis more likely. It also could be inadequately-resected cartilage. It takes noses a full 6-12 months to completely settle and scar tissue to mature after rhinoplasty, so you have answered your own question about potential steroid effectiveness that long after surgery (but only if it's scar tissue).If you were my patient, I would start steroid injection very gingerly now, using 0.1cc of 10mg.cc triamcinolone and checking effectiveness at 6-8 weeks. Nothing or minimal response is OK, as I can always increase concentration up to 40mg/cc and also increase dosage. But start conservatively, since some patients respond aggressively, and you don't want a dent!I think if you wait until a full year has passed you may have missed a window of (better) opportunity. But that's just my opinion after 27 years of doing cosmetic rhinoplasty. Talk with your surgeon. Best wishes! Dr. Tholen
Helpful 1 person found this helpful
September 7, 2014
Answer: Poly beak after rhinoplasty? Poly beak after rhinoplasty? Wait 6 months and if not better u will need a revision by your surgeon or a revision rhinoplasty surgeon.
Helpful
September 7, 2014
Answer: Poly beak after rhinoplasty? Poly beak after rhinoplasty? Wait 6 months and if not better u will need a revision by your surgeon or a revision rhinoplasty surgeon.
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