Four Kenalog Injections and Nose is Still Swollen

Question

I'm African American & have really thick skin. I'm 9 months post-op, but nose is still swollen. I'm not happy, it still doesn't look like it did when my splint came off.I've had one 10 mg/cc,one 20 mg/cc,and TWO 40 mg/cc kenalog shots injected in my nose. It does seem like the shots help SLIGHTLY but not that much of a difference. Sometime, it seems my nose looks better 1 or 2 days after the shot, but then it swells back up again.Should i get more or should i stop. I get them done every 6weeks.

Michael M. Omidi, MD, FACS · Answer

It is important to know that kenalog can have significant side effects when injected in the nose.  The thinning is usually performed in surgery with the cartilage and thinning of the flap.  Nose Job Recovery

If a full rhinoplasty is performed with reshaping of the nasal
bones then you will have a splint on the nose.

The splint will remain on for one week.  Packing is rarely used for the nose and if it
every is used it will have a channel so you can still breath making it more
comfortable.

You should keep your head elevated after surgery with a few
pillows to minimize swelling.  We don’t
recommend ice on the nose but it is helpful to use it for the first 24 hours
around the eyes.

After 1 week the splint is removed.  Sometimes we will tape the tip of the nose
for an additional few days to keep the swelling down.

Most patients feel good at one week when the splint is removed
and can start light duty work.

We ask that nothing strenuous be done for 4-6 weeks.

Majority of the swelling resolves from 6weeks to 3 months,
however, there is some residual swelling that may take up to 6 months to fully
resolve.

Since we rarely place an incision on the outside of the nose,
there is much less swelling on the tip with faster recovery.  Best of luck, Dr. Michael Omidi

An in-person exam with a board-certified plastic surgeon is the
best way to assess your needs and provide true medical advice.  The response to the question does not constitute a doctor patient relationship or formal advice.

Aaron Stone, MD · Answer

It sounds like you already know the answer. Repeated kenalog injections especially 40mg/cc solutions can cause problems with skin color, surface contour etc that are not fixable. There are other ways to handle swelling such as keeping the head elevated, sleeping on 2 pillows, application of warm compresses, compression (although that is difficult on the nose). Not knowing exactly what was done at surgery (cartilage grafting, placement of an implant etc) no one here can really advise you what to do. If you had an implant placed and these are signs of infection that implant may need to come out.

	My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Anita Mandal, MD · Answer

If the swollen area is localized, I would consider increasing the frequency of injection as long as it is due to soft tissue and not due to underlying cartilage. If it is generalized swelling all over your nose, you may want to consider a series of chemical peels such as glycolic acid to help with the swelling. Swelling, particularly in thick skinned individuals and african american, can take a long time to resolve.

Four Kenalog Injections and Nose is Still Swollen

Answers (3)

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