How Long Should I Wait for Kenalog Injections to Take Effect in the Nose?

Since steroid injections work by breaking the bonds between collagen (scar) bundles, the effect of localized steroid injection is to reduce scar tissue bulk beneath the surface of the skin. These injections need to be skillfully placed deeply enough to avoid excessive shrinkage of the normal dermis, causing depression and thinning of the skin. That is why most of us who perform steroid injections to improve results do so conservatively, starting with low doses. I usually wait 6-8 weeks so that I am not inadvertently "double-dosing" and causing excessive thinning. You can always inject more and stronger, but it is impossible "take it back" if the response is more than anticipated.

Be patient and follow your surgeon's advice; it sounds as if he or she is following good practice by starting conservatively. Good luck!

Kenalog is sometimes useful to dissuade robust inflammation and scarring after rhinoplasty.  Effects are usually noticed in 1 week with maximal results seen in a few weeks.

It’s not unusual for patients to experience significant
swelling following rhinoplasty surgery. This swelling may persist for 12 to 18 months following surgery and
results in the nose being extremely stiff. When this situation arises, steroid injections are occasionally
helpful.It’s important to use steroids
judiciously because they can cause hypopigmentation, spider veins and skin
atrophy.Patients
frequently notice a response to steroids within 2 to 4 weeks of injection. Initially it’s important to utilize small
amounts of steroid to avoid complications. Injections can be repeated at 6 o 8 week intervals.Swelling
usually resolves with the passage of time. For this reason, patients considering steroid injections should consider
the pros and cons of this maneuver before proceeding.

Steroid injections following rhinoplasty are indicated when there has been excessive scar tissue production deep to the skin - this manifests itself by the appearance of swelling. This is most commonly in the supratip (area just above the tip) or tip regions. Steroid injections typically take about 2-3 weeks to start to work. They should be used judiciously as when too much is injected or injections are performed to frequently, they can cause excessive thinning of the skin or loss of pigmentation that can take a long time to resolve. If further injections are required, they are typically done at least 6 weeks after the previous injection. It is better to be more conservative using steroid injections following rhinoplasty than be too aggressive.

Dear 3802anon,

I usually wait about a month in between injections.  It takes about this long to see the result from injections.  The injections are really nice at bringing down swelling.

Best,

Nima Shemirani

Kenalog-10 is occasionally used in the "supra-tip" area for stubborn swelling. Dilute Kenalog may start working as soon as 1-2 days following your injection, and the drug is almost completely out of your system by one month after your injection. In that regard, a repeat injection may be performed 2-4 weeks after the first.

Hope this helps. Dr Joseph

Hi 3802anon in Texas -

Many patients see a response in the first two weeks. Often more than one injection is indicated. The spacing of the injections is usually 6-8 weeks. Also, there are different strengths of Kenalog. One usually starts with a weaker strength.

Sincerely,

Tom Kaniff

Kenalog injections are frequently injected in the supra tip area of the nose during the first few months after the rhinoplasty procedure to help prevent fluid  and scar tissue accumulation  in that area. The injections usually take approximately one week before the patient notices any effect. Thick skin individuals usually  require more than one injection. For many examples of rhinoplasty, please see the link  below

Kenalog injections work by inducing apoptosis (programmed cell death). This effect, plus the dissolution/dissapearance of the dead cells, takes several weeks to occur.

Treating again too soon generally results in overcorrection/overdoing it. Your surgeon is wise to go slow.

I typically use Kenalog for the small group of patients with persistent swelling above the nasal tip after undergoing Rhinoplasty. The earliest I will inject is usually 6-8 weeks after surgery. Injections can be repeated as needed in 3-6 week intervals depending upon the degree of persistent swelling and the clinical response to the treatment. The Kenalog begins to work immediately but it may take weeks to months to see a definite result. Results may also depend upon the dosage of Kenalog used by your surgeon. Kenalog will not correct problems related to under-correction of the cartilage of the lower nasal bridge or inadequate correction of poor tip projection - both of which may create undesireable supratip prominence. Best of Luck - Dr Harrell