How Long Should I Wait to Get Steroid Injection to Dissolve Scar Tissue After Rhinoplasty?

You should definitely consider a kenalog injection.  First, it can be done safely as early as a month post op.  Second, it works.  Not only does it soften some of the early firmness associated with surgery, but it also prevents the deposition of scar tissue.  Third, it does not induce soft tissue atrophy if used in the correct plane and the correct concentrations.  You will see that most of the physicians who suggest kenalog all mention small amounts, spaced at least 4-6 weeks apart.  Done properly, you will not see soft tissue atrophy.

There are a number of studies that support the use of kenalog, so you don't have to just take our collective word on this.  Some, like an article a few years ago by Pastorek, suggest it's use in almost every rhinoplasty.  So I can assure you that it is safe, effective, and standard of care.  And from what you describe about your experience, it sounds like just the ticket.

Hi Grimesland,

Steroid injection with a low dose of Kenalog-10 may be a perfect treatment for the swelling in the area just above the tip (the supratip region).  Sometimes, scarring can occur here and injections of steroid can help reduce this swelling.  However, swelling after rhinoplasty is VERY common and is usually not cause for alarm.  Discuss this with your facial plastic surgeon and determine if she would consider a steroid injection.  

Hi Grimesland,

3 months after rhinoplasty is not too soon to have a small dose of Kenalog-10 (steroid) injected into swollen areas of the nose.  In fact, many rhinoplasty surgeons have injected open rhinoplasty noses as soon as one to two weeks after surgery.  Enjoy your new nose. 

Dr. P

Dear Rhinoplasty patient from Grimesland, NC
It is difficult to render a professional opinion based on your description. I agree with Dr. Ridgway regarding formation of ploy beak deformity. This can occur as result of scar formation at supra tip area. Three months after rhinoplasty, it is reasonable to have Kenalog injection to prevent further hardening of scar. Talking to your surgeon is the best way to have your problem resolved.
Good luck and good healing
 

From what you have described you are developing rounding and fullness along the nasal tip. Concerns for developing a poly beak deformity secondary to scarring in the supratip region exist. Without an image to review any commentary is speculative, but if you developing this form of scarring you will want to have a Kenalog injection (steroid) performed now before things are too late, not too early. You should contact your physician.


Best regards,
James M. Ridgway, MD FACS
 

I must admit that on open rhinoplasties especially I will inject very small amounts in the supra tip starting at about 1 month postop.  I find this is needed mostly in patients with thick skin.  I will not reinject for at least 6 weeks after that and only if really needed.  Be patient, some doctors follow this while others don't, it's a very individual thing and I don't do it on every patient.

You did not provide pictures, but what you are describing sounds like supra tip fullness after a rhinoplasty. You may be developing a poly beak deformity.(development of scar tissue)  I would refrain from injecting steroids for fear of skin atrophy. I would wait 6 months and if this had not resolved, you may need a revision.

Three months would be the earliest I would start steroid injections.  You require a series of injections using low concentrations of steroids to avoid skin irregularities from the steroid injections.

I do not like to inject steroids into nasal tips because I think it may cause soft tissue atrophy and other skin issues.  At 3 months there still is a fair amount of swelling and this dissipates gradually over 6-12 months.