Pollybeak deformity? 11 months post open rhinoplasty. (photos)

Question

I had an open rhinoplasty 11 months ago. All went well but lately, I've been very worried that I might be developing a pollybeak deformity. When would a doctor be able to see if this is happening? At a certain point, is a patient "out of the woods" with any complications occurring? Thank you.

Steven M. Denenberg, MD · Answer

If it's getting full just above the tip, and it's soft, like scar tissue (a polly beak is usually scar tissue), it can be possible to inject some steroid into the area and it might help. It's extremely unlikely to harm your nose.
The profile line seems a little full below your tip, too, and if that's scar, it might respond to a shot as well.
There are some people who think that the steroid shots don't do anything that the nose won't eventually do with time, though, so it's not an emergency, and it's not even clear-cut that it's a good solution.
If you do eventually have a revision, consider whether to elevate the tip, too. I made a morph of your nose, showing some elevation of the tip and some movement of the tip back closer to your face. Click on the "Learn more" link, just below my response, to see it, or go here:
FacialSurgery.com/RealSelf/RealSelf_carrie380.html
Sometimes if the tip is a bit low, it makes it look like a bit of a polly beak, too.
I hope some of this makes sense. Does your surgeon think it's a polly beak, deserving of some steroid?

Eric M. Joseph, MD · Answer

Based on your photos, you do not appear to have a poly-beak deformity. A poly-beak is when the lower bridge is higher than the nasal tip, and you do not appear to have that issue. Consider re-asking your query with before photos. Thank you. Dr Joseph

Umang Mehta, MD · Answer

Hi and thanks for the question. It does look like the lower half of the bridge is slightly taller than the upper half on profile view. Ask your surgeon her or his opinion re: the issue. An exam could help determine if this is due to the bone/cartilage height or whether there is residual swelling or scar tissue in the supratip. For certain patients, a Kenalog (steroid) injection can help if it's the latter issue. If it is the height of the bone and cartilage and you're not interested in revision rhinoplasty, nonsurgical rhinoplasty (filler) could also be an option. Best regards,Dr. Mehta

Prashant Soni, MD · Answer

occasionally, a gradual increase in fullness over the lower portion of the nasal profile can be reduced by a dilute steroid injection. Your surgeon should be the one to decide if this is appropriate for you. Another consideration is to use an injectable filler to blend the contours of your nose. Speak to your surgeon about these options. Having said this, your nose appears quite natural and elegant  and I would have you  consider doing nothing for the time being.
Best Regards,
Prashant Soni M.D.

William Townley, MD, FRCS(Plast) · Answer

Dear Carrie,Thank you for the post. The most important questions to ask is how you feel about the new shape of your nose. If you are happy, then there is not need to worry. There are various terms used to describe different nasal shapes associated with outcomes of rhinoplasty surgery. These include pollybeak deformity, inverted V-deformity etc. - they do not represent a functional problem that needs fixing but an appearance associated with surgery that may be undesirable. In the photo you have posted, there is a suggestion that the bone has been resected more than the cartilage, which is  feature of the pollybeak. It is mild and probably present on a significant proportion of patients undergoing dorsal side profile surgery but it is always best to contact our surgeon for a further discussion if you have any concerns about the outcome of your operation.

Pollybeak deformity? 11 months post open rhinoplasty. (photos)

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