Do You Always Need Multiple Kenalog Injections?

Hello, I had an open revision rhinoplasty 17 months ago. I was experiencing intermittent swelling. 4 wks ago, my surgeon injected kenalog into my nose. It has helped greatly in refining my nose and it looks just how I wanted it to. My question is, will this effect last? Is more than one injection always necessary? I am afraid that it will swell again once the medication wears off. I do have fairly thin nasal skin - I think because it was a revision I just had too much scar tissue under the skin

Doctor Answers 6

Kenalog injections after rhinoplasty

The kenalog isn't going to "wea off" because it's already exerted its effect, which is to break up and thin some of the scar tissue.  There is always the chance that you may reform scar tissue, but since you had such a nice response to it this time around I suspect that you should be able to manage it with a repeat injection if warranted.  If your nose looks great, no need to inject it again right now.    

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 57 reviews

Steroid Injections and dermafillers after rhinoplasty can prevent need for revision surgery

After the many techniques performed during rhinoplasty surgery, the healing process in out of the surgeon's hands and we must wait and observe.  Some of the changes that occur over the months of recovery: scar tissue, shifting of grafts and bone, skin thickening or thinning; are just as important as the techniques the surgeon performed during the surgery.  Much of what the surgeon performed can be altered during the healing process.

There are three maneuvers that may be performed after surgery that can help tweak a result and keep a patient from needing a second surgical procedure:

  1. Steroid injections-These are performed frequently and can be helpful for decreasing scar tissue, especially in the supratip area.  They may need to be performed more than once.
  2. Percutaneous modeling- Using a needle, a surgeon may be able to make small refinements of cartilage grafts, softening the edges in the office.
  3. Dermafillers- Fillers may be used to fill concavities or add definition to areas like the tip

In direct answer to your question, steroid injections are commonly used after rhinoplasty surgery.  You may require multiple injections.  With time however, the results will stabilize and you shouldn't require them forever.  There is a slight risk with steroid injections of making the skin too thin.

Good luck in your search for information!

David C. Mabrie, MD
Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 105 reviews

Do You Always Need Multiple Kenalog Injections?

I have performed Rhinoplasty for over 20 years and when it comes to post Rhinoplasty healing and kenalog use, every noise is different.  Typically, kenalog doesn't do much, IMO at 17 months post op Rhinioplasty but if it worked, it worked.  wait and see if the swelling returns and then follow the lead and instructions of your Rhinoplasty surgeon.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Scar tissue after nose surgery

Some patients are prone to develope scar tissue after procedures. Depending on the patient one injection may be all that is necessary, others may require multiple injections. The concentrations are very dilute and rarely cause a problem. Some people may be very sensitive to the steroids, and can cause thinning of the skin or dimpling.

Brian Maloney, MD, FACS
Atlanta Facial Plastic Surgeon
4.7 out of 5 stars 30 reviews

Kenalog injections

This falls into the "art of medicine". It is helpful and effective when needed. There is no reason to think it will be repeated need for you and that you won't maintain the result. Think of it as gardening or a vineyard. You do the tilling and planting (the surgery) but then you monitor it and do the weeding and pruning as necessary to maximize the yield.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Kenalog injections common for revision rhinoplasty

I routinely perform kenalog injections for my revision rhinoplasty patients on an as neeeded basis. Most, if not nearly all revision rhinoplasty patients will have persistent swelling in the nose that will create the need for an injection of the steroid solution. This is typically a permanent improvement, but if needed, the injections can be repeated. I have had a few patients over the years that required multiple kenalog injections to ultimately give them the result that we wanted. Be patient and keep your follow-ups with your surgeon.
Andrew C. Campbell, M.D.
Board Certified Facial Plastic Surgeon

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

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.