19 months post op, can injections help polly beak deformity? If so, where can I do them. (photos)

Question

Hi! I went to Istanbul, Turkey, to get a nose job for my bumpy and bulbous nose (closed, thick skin) After 3 or so months of the procedure, I noticed I had polly beak and was told to just wait. Its been now 19 months since my procedure, I want to see if I can find a doctor that can perform steroid injections to perhaps help? I really dont want to undergo another rhinoplasty. What can I do?

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photographs.

I am sorry to hear regarding your post-operative concerns.

The first thing I would suggest would be to contact your surgeon and discuss the solutions they would propose. They had direct assessment of your nasal soft tissues and may be in a position to offer better answers.

In terms of general management pathways, there are several options available:

- You can allow more time for things to settle before taking action as thicker skin typically has a longer cycle of recovery that can span to approximately 3 years

- Steroid injections to see if the supratip volume can be reduced. If the steroid injections only have a temporary effect, it can be that the problem is related to the amount of blood flow through the skin and would not be stabilised in the long-term by steroids .

- Accutane which is normally prescribed for management of acne has also been shown to reduce the soft tissue thickness around the nasal tip and supratip following rhinoplasty. It is a more challenging medication and requires close supervision by a dermatologist.

- Nonsurgical tip augmentation using injectable fillers. This approach can produce a change in shape of the profile and semi profile and would require repeat treatments to maintain the effect

- Surgical tip augmentation which would normally be combined with further reduction in the thickness of the tissues of the supratip. It would more likely involve an open approach

- Finally, one of the techniques that has been used for control of the soft tissue polly beak is removal of an ellipse of skin in the supratip area. This leaves a mark in the supratip region which is relatively faint but nevertheless represents a permanent scar.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.As far as I can see from your photo to make your nose more elegant and the way you want it to be I recommend you revision rhinoplasty.It would be better face to face consultation.Best regards!

John Michael Thomassen, MD · Answer

It would be best to undergo a revision rhinoplasty to address this and not do steroid injections as these could have adverse effects on the skin and not correct the issue at all.  You also appear to have developed significant asymmetry of the nasal tip/ala region that steroids will not correct.  Obtaining the operative report from Turkey would be helpful.

Zoran Potparic, MD · Answer

Although this type of deformity is best treated immediately after surgery with series (2-3) of topical steroid injections, this can be tried even now. However, your presentation with poorly defined tip, still very thick tip/dorsum skin is calling for more surgery; thinning of skin, structural tip graft(s), reduction of Supratip portion of dorsum?? In person consultation with a board certified plastic surgeon with expertise in rhinoplasty, is recommended. Good luck.

Darryl J. Blinski, MD · Answer

The series of posted after photos slightly help but need to see before photos to compare. My guess is steroid injection are the WRONG option! I think you need revision rhinoplasty to correct excess tissue/tip cartilage left from the initial rhinoplasty in Turkey. Best to seek in person or virtual consults... Fee for revision $6,000-$12,000.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum1
Your early postoperative result appears acceptable although the nasal supratip was already positioned slightly above the level of the nasal tip. As the swelling subsided, the residual deformity (of high supratip and lack of tip support) evolved. 
Injectable steroids are a potent tool to lessen postoperative swelling rapidly by lessening inflammation and preventing collagen deposition in the area of recent surgery. It is not without potential complications of skin pigmentary change, dermal atrophy, and small blood vessel prominence in the area of treatment. 19 months after surgery there is most likely not much swelling or inflammation to resolve. 
Of course, an in-person evaluation is required to assess your specific problem.
You may be a potential candidate for a secondary rhinoplasty addressing the tip and supratip with trimming of the supratip and addition of a cartilage graft for tip support. 15% of cosmetic procedures benefit from secondary touch up surgery. 
Revisit your plastic surgeon for evaluation and discussion.
Best wishes...

19 months post op, can injections help polly beak deformity? If so, where can I do them. (photos)

Answers (6)

More Rhinoplasty Questions

WE SEND PRETTY
EMAILS

Answers (6)

More Rhinoplasty Questions

Can't breathe well from left side of nose. What can be done for breathing issues/asymmetrical nose? (photos)

Years ago I injured my left nasal bone due to trauma. What procedure will restore the bone to its original place?(photo)

2 years post op rhinoplasty swelling still. Would I benefit from an injection? (Photo)

Is there any other way to lengthen nose besides adding cartilage graft?

Is there a way to lengthen the nose to make midface look longer? (Photo)

Can a crooked septum be fixed successfully using ear cartilage? Is it too soft to use on the septum? (photo)

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS