Do steroid injections change the final result? Or only speed up the healing period? (post-op rhinoplasty)

Question

I've had rhinoplasty surgery 6 months ago. I think I still have some swelling on the tip of my nose. Should I get steroid injections or just wait? Will the final result be the same at the end? Do steroid injections change the final result in a positive way compared to just waiting more? Waiting is not a big problem for me. Thanks for helping.

Ronald J. Edelson, MD · Answer

Steroid injections to the nasal tip after rhinoplasty are an excellent tool to bring down swelling and refine the nasal tip. I do this quite often. If a patient has swelling in the tip that is excessive at three months I will start injections and usually do a total of three a month apart each. Different surgeons have their own regimen.

Jason Emer, MD · Answer

I recommend getting a formal evaluation with a cosmetic dermatologist to go over your desired results. Facial fillers like Voluma, Restylane, and Juvederm along with Botox can be used to improve the symmetry of the nose and lift the tip; however, it won't make the nose appear smaller. Surgery would be needed to improve the nostrils or overall shape. See an expert. Best, Dr. Emer

Eric M. Joseph, MD · Answer

In our practice, steroid injections are only used after rhinoplasty to treat swelling above the nasal tip - in the supratip. This may accelerate resolution of swelling, but it is not clear whether it would effect the final result. I don't think it does affect a final result, but it may get our patients there a bit sooner. Great question. Dr Joseph

Esra Eryaman, MD · Answer

We have to be very carefull with steroid injections, They have to be very small in dose, other wise they melt the tissue excessivly making cavities on the nose.

William Portuese, MD · Answer

When patients have thick skin, the steroid shots are managing the soft-tissue envelope over the framework of the nose. The surgery itself changes the cartilage and bone structure of the nose. The steroid shots themselves are just as important as the surgery itself managing swelling in the soft-tissue envelope over the framework of the nose. Close postoperative follow-up appointments with your surgeon  are required to manage swelling in the tip.

Blake Raggio, MD · Answer

Residual swelling in the tip of the nose is an unfortunate but relatively common happening after surgical rhinoplasty.Not only is the amount of swelling difficult to predict, but also the duration as well. This is due to several factors, including the extent of surgery performed, the skin thickness of the patient, and the patient's intrinsic ability to heal, among other things.
With that being said, steroid injections into the nose can be useful in hastening the resolution of residual tip swelling. Injection habits/techniques vary by surgeon, but typically can be done beginning 2 months after surgery.
To answer your question, the steroid injections generally do not change the overall result, but rather "get you there" a little quicker. Please note; however, that steroid injections are not without their own side effects and may in fact cause fat atrophy or cartilage/graft resorption which can result in asymmetries and/or contour irregularities.
Regardless, I recommend you see your rhinoplasty surgeon, or someone experienced in surgical rhinoplasty (e.g., board-certified Facial Plastic Surgeon) so that you receive an expert opinion.
Good luck, and hope this helps.
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Blake Raggio, MD

Do steroid injections change the final result? Or only speed up the healing period? (post-op rhinoplasty)

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