Kenalog injections to refine nose tip in thick skinned patient? (rhinoplasty 3 years ago)

If too much cartilage was removed, then your tip will look amorphous and round. Kenalog can help with the internal scar, but your main issue is the need to build a strong internal support structure of cartilage to get the tip back to a nice shape. I would most likely use some kenalog in conjunction with a planned revision rhinoplasty.

It seems that you need a revision in which the nasal tip's architectural integrity must be preserved. It is almost always ideal to use grafts derived from the septum (wall between the nostrils), ear, or rib because they do not cause implant-related problems such as protrusion, visibility, etc.  The rate of short- and long-term complication is also notably low with the use of natural tissue. Kenalog injection, meanwhile, is a temporary solution.  Oftentimes, it is used to control persistent swelling, a common concern of ethnic rhinoplasty patients whose skin is generally thicker compared with Caucasians'.To determine what really needs to be done, go to a board certified plastic surgeon (preferably certified by the American Board of Plastic Surgery) who mainly performs revision rhinoplasty.Good luck and best wishes. 

The best way to create nasal tip refinement during Asian rhinoplasty is to create greater structural support for the tip of your nose, rather than to simply attempt to thin out the skin.  Kenalog injections may help to a certain degree, but only if you have appropriate tip cartilage support and strength.