Do Kenalog injections bring only temporary improvement?

Kenalog injections are helpful in reducing swelling in certain areas of the nose.  They should be used with caution and in very minute amounts, as they can cause atrophy or depression.

 Very often patients come back to improve swelling after rhinoplasty. Many times this mild swelling can be taken care of by using a steroid injection. More times than not the steroid results are permanent however in some cases patient continued to have “internal keloid“.  In over 30 years of experience I find that few people do have continued problem with retained or continued swelling and must be treated every 6 to 9 months.

Kenalog is helpful reduce early swelling and scar formation after rhinoplasty though it is not without risk. Side effects can include atrophy or a thinning of the tissue which can be permanent. It is always best to be cautious and patient with results.

Kenalog and other injectable steroids  are useful tools to diminish nasal fullness in the healing process. Steroids like Kenalog can inhibit or slow collagen production making the result long lasting and potentially permenant. Given the potential for thinning of internal scarring long term, it is best to use these injections sparingly, and to avoid using them for normal post operative swelling. Using them too soon while there is already swelling present makes it hard to guage whether it is needed and may result in over thinning.

Hello. I am Dr. John Minoli from Henderson, Nevada
& Las Vegas, Nevada - board-certified in general plastic
surgery, facial plastic surgery & otolaryngology (ear, nose
& throat).
If swelling exists along the supra-tip of the nose, yes, kenalog may indeed be beneficial as it seems to have been with you. I would caution against an over-aggressive use of kenalog injections to the nose for fear of irreversible skin atrophy. Briefly, kenalog has a role in reducing postoperative nasal swelling during the first postoperative year, but it should not be used too much or too often.

Steroid injections are very effective at reducing the amount of scar tissue within the nose, however, they are not without their own risks.  Their effects are not specific to scar tissue alone and may cause undesirable atrophy of the surrounding tissue.  Furthermore, the effect of the steroid can work for quite some time, so it is possible that you were still getting some effect from your first injection at the time of your second injection.  
I would recommend being very patient with the swelling and try other modalities such as taping.  Steroids are fine, but I prefer small doses spaced at about 6-8 weeks in conjunction with taping at night.  For my patients, this has been an effective regimen to speed up the resolution on swelling.  
 

Reduction in swelling with Kenalog injections after rhinoplastyare usually permanent but it may take several treatments to achieve the desired results. However, proceed with caution because you don't want to cause a depression secondary to the injections.