12 months post rhinoplasty and nose is bigger - Kenalog shot provides temporary help. Could this still be swelling? (Photos)

Question

I went in a year ago for a rhinoplasty and now my tip is bigger and my nose more masculine than prior. I simply wanted tip refinement, I’ve had several rounds of kenalog shots they seem to help somewhat but then in 3 months I’m back to the same place. Also I’m not over the moon even with the kenalog shot. Is this still swelling I’m so worried I ruined my face. First pic is prior rhinoplasty second is 11 months post.

Steven M. Denenberg, MD · Answer

If you've had "several" kenalog shots, it's probably time to quit them. You only posted that cropped frontal view, but it seems to make your nose appear long-ish, and you mentioned that your nose still looks masculine. Do the profile and 3/4 views make the tip look low as well? If so, then a revision is what could elevate the tip and possibly do more for the size of the tip. The good news is that, in expert hands, elevating the tip, even in a revision, is one of the more predictable changes to make in surgery.

How *much* to elevate the tip, or narrow the tip, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision. And it also discusses how to take photos that are best for online evaluations.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question. As far as I can understand from your question and photos if you want permanent solution I recommend you revision rhinoplasty. With a revision your nose will be looking more defined, and slim. Now it is looks like bulbous. It would be more convenient to decide with face-to-face consultation. Best Regards!

Celal Alioglu, MD · Answer

Hello you need to have a second surgery because you had a deviation you need a correction for the surgery

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, your nasal tip lacks definition. This is a typical postoperative photo 12 months out and is due to residual swelling. 
Rhinoplasty is a very traumatic procedure...The nasal bones are stripped away from the overlying musculature and the underlying nasal mucosa. The bones are fractured and repositioned. The nasal cartilages are stripped away from the overlying skin and underlying nasal mucosa and segments are surgically removed. 
As a result, postoperative swelling may initially be paramount. Swelling is due to inflammation and is composed of tissue fluid, providing nutrition to the healing tissues. Although 60-80 % of the swelling diminishes over the first 6 weeks, it takes 18 months - 2 years for all swelling to subside. The nasal tip is notorious for taking the longest time. 
Kenalog is a corticosteroid and as such it retards inflammation / swelling and may prolong the period of healing. 
Best wishes...

12 months post rhinoplasty and nose is bigger - Kenalog shot provides temporary help. Could this still be swelling? (Photos)

Answers (4)

Answer: Concern about "bigger nose" 12 months after rhinoplasty

Answer: Concern about "bigger nose" 12 months after rhinoplasty

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Everything you need to know about Rhinoplasty

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12 months post rhinoplasty and nose is bigger - Kenalog shot provides temporary help. Could this still be swelling? (Photos)

Answers (4)

Answer: Concern about "bigger nose" 12 months after rhinoplasty

Answer: Concern about "bigger nose" 12 months after rhinoplasty

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Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.