I am terrified of developing a pollybeak deformity. My surgeon is concerned because of my thick skin. He said earlier in his career he had a few cases, but he has since been suggesting taping for 8-12hrs/night for at least 1mo post-op and has had few cases. What are the odds of me developping one? By when would it have appeared? What other measures can I take to avoid this? What can he do if it does happen?
Anything I Can Do to Avoid Developing Polly Beak Deformity?
Doctor Answers 6
Supratip Fullness and Pollybeak Deformity in Rhinoplasty
As plastic surgeons have stated, polly beak nasal deformity may due to several causes. Supratip fullness (polybeak deformity) may be due to swelling alone, especially very early after rhinoplasty surgery. Excess tip cartilage and/or insufficient tip support, active nasal muscles, and scarring are other potential sources of supratip fullness.
Thick skin usually holds edema and swelling longer than thin skin. The nose will continue to change gradually over time. Some plastic surgeons use nasal taping long after the initial surgery, but most cosmetic nasal specialists found this not to be helpful. Occasionally, steroid injections in appropriate patients may help treat supratip fullness.
Rhinoplasty is not one operation, but rather many potential operations. Speak with your rhinoplasty surgeon to help determine appropriate options for you.
Avoiding a Pollybeak
A pollybeak forms when tip projection is not adequate or the cartilage along the profile line is left too full, frequently in a thick-skinned patient. The bst way to avoid a pollybeak is to pick an experienced surgeon.
Most pollybeak deformities are caused by insufficient removal of the dorsal septal cartilage. An open rhinoplasty approach is a good way to prevent this because it allows the visualization of the entire cartilage as opposed to a closed approach where visualizing the dorsal cartilage may be more difficult. I don't believe tapping helps.
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Preventing pollybeak deformity
Pollybeak is a very common problem in rhinoplasty practice. For patients who are likely to develop pollybeak, we place an injection of Kenalog into the skin at the time of the surgery. We closely follow up at three weeks with another injection. We will also perform another couple of injections over the course of the first few months with close postoperative monitoring for this. We also use Blenderm tape starting in a month and patients can use this at night for the first few months after their surgery and this helps as well. Close postoperative follow up with your rhinoplasty surgeon is important.
Avoiding polly beak deformity
Absolutely choosing a great rhinoplasty surgeon is key. Particularly a surgeon who understands your skin type, your concerns and will take the surgical steps required to prevent the pollybeak. Some of these steps include providing good tip support, resecting appropriate amounts of cartilage and monitoring postoperative swelling. Even still, thick skin can be a challenge. If you suspect a pollybeak deformity developing make sure you see your surgeon post-operatively. Occasionally, surgeons can use injections to help with swelling. Good luck!
The best treatment for pollybeaks in rhinoplasty.
I have done rhinoplasty for more than 35 years and I do not think taping works. Polly beaks are usually the result of the cartilage being left too high or the skin being very think and does not want to flatten out about the tip. Go to a good, experienced rhinoplasty surgeon for the best way of prevention of this.
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