Success rate of a pollybeak?

Hi, i had an open septorhinoplasty over a year ago and have developed a pollybeak. After seeing my surgeon he said i need revision surgery...I am now due to see a new surgeon about this & am just wanting to know how hard this is to fix? Was told by my original surgeon he would need to take cartlidge from my ear...really need this sorting and am worried it might happen again :-/ thanks in advance x

Doctor Answers 2

Pollybeak deformity

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Without any pictures and frankly without an examination in person, it is impossible to answer this question. There are several different causes for the pollybeak deformity: (1) prolonged edema or scar tissue formation in the supratip, (2) excessive dorsal hump resection, or (3) poor nasal tip support/underprojected nasal tip. As one can imagine, each cause of pollybeak requires a different treatment modality. In the case of excessive scar tissue or prolonged supratip edema, sometimes steroid injections (Kenalog) can help. For the other causes, revision surgery is typically necessary, which requires cartilage for grafting purposes. If the nasal septum was utilized during the initial rhinoplasty operation for grafting, cartilage from a secondary donor site might be necessary, either from the ear or rib. However, such would be an intraoperative decision as there is no reliable test to determine whether or not sufficient septal cartilage is available for revision surgery.

Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 29 reviews

Pollybeak Deformity after 1 year Rhinoplasty

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A true pollybeak deformity is caused by scar/fibrous tissue developing over time, in an area of the supratip bridge from too much "space" left between the nose and the skin envelope due to reduction of cartilage. If you have a true pollybeak, cartilage graft reconstruction and removal of scar/fibrous tissue can and does help. Often surgeons will try kenalog injections to the nose first to see if steroids will help reverse the scar tissue and shrink the skin and soft tissue envelope. If not, often revision rhinoplasty options could be considered. If you are confident and trust your original surgeon, discuss your concerns and expectations completely in advance of your revision. Second opinions can validate the appropriate next step, but may lead to some confusion as to your best plan of action. After you see another surgeon, I would return to your original physician to discuss any new or different recommendations. This could help sort things out for you and decrease your worries. Take your time, as there is no need to rush into a decision until you are completely comfortable. Best wishes. 

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.