Rhinoplasty supratip swelling 3 months post-op? PS mentioned steroid injections before removing scar tissue. (photos)

Question

I had a rhinoplasty on 7/31/18. Also, I have thick skin, and a bit oily. 3 mnths post-op and i still have much significant swelling on my tip, surgeon says I need to be more rough on massaging my nose to get rid of the swelling. But I don’t like the downwards appearance of the tip of my nose i think it looks uneven on both sides if that makes sense. tip looks very big and bulbous. He mentioned if it doesn’t improve he’d have to do steroid injections before even considering removing scar tissue.

Nirmal Nathan, MD · Answer

Dear Milla3080,Thank you for your question. It is not in common for patients to be concerned about their tip 3 months after surgery. I always tell my patients that it really takes 6-12 months to see the tip definition and form return. Steroids can help but it is really just time. Depending on how your tip feels and looks on exam, a determination if steroids are indicated can be made. Hope this helps.Nirmal R. Nathan, M.D.Certified, American Board of Plastic SurgeryMember, American Society of Plastic Surgeons

Eric M. Joseph, MD · Answer

It's difficult to judge your outcome without seeing your before photos. You are certainly swollen, but you may not have supratip swelling. We reserve steroid injections after rhinoplasty for supratip swelling that may resemble a "poly beak". Your tip may appear a bit droopy, but without a before photo, there is no way of knowing whether this was improved. I do not think your nasal tip will spontaneously lift, with or without a steroid injection. Consider sitting tight and doing nothing for another few months to allow more swelling to resolve. If you're dissatisfied with your nasal appearance 6 months postoperative, you can discuss this with your surgeon, and consider a second opinion from another rhinoplasty specialist. Hope this helps. Dr Joseph

Ram Kalus, MD, FACS · Answer

Without examining you in person it is difficult to make any specific treatment recommendations. That said, I would strongly disagree with a steroid injection which can have irreversible effects on the delicate soft tissue of the nasal tip and supratip. If things don’t improve with time (6 months) I would be open to the possibility  of revision rhinoplasty. If in doubt, please consider a second opinion evaluation with an experienced board certified plastic surgeon. Best of luck to you.

Paul N. Afrooz, MD · Answer

Roughly massaging the nose is generally not advisable after a rhinoplasty, but your surgeon may have a specific reason and way of doing this that will not jeopardize your outcome. Based on these photos, you don't seem to have significant supratip swelling, but rather just a lack of nasal tip projection which is giving your nose the downward appearance that you mentioned, and also creating roundness in the supratip area.  If it is in fact swelling in the supratip, I usually recommend starting with a taping regimen before moving to steroid injections.  Perhaps you can discuss this possibility with your surgeon.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
The performance of rhinoplasty
involves the separation of the nasal bones and cartilages from overlying
and underlying structures, fracturing the nasal bones, removing excess
bone / cartilage, reshaping of the remaining bone and cartilage. The
significant intraoperative trauma causes swelling (which may be
asymmetric), which will make your nose look large and wide, and perhaps crooked. This will improve
markedly over the first 6 weeks, but will take at least a year for your
nose to assume its final shape and size. The nasal tip is notorious for taking the longest time to achieve definition.
We do not recommend steroid
injections early on as most if not all swelling will resolve spontaneously
over time. Steroid injections carry the risk of thinning of the skin (atrophy) overlying the injection site. In our practice, we consider it cautiously if there is no improvement of nasal swelling after a period of
6 months. Is it swelling or residual underlying bone / cartilage prominence? If the tissues are soft and free of residual redness, this may represent a residual prominence, requiring secondary revision. 15% of cosmetic procedures require a secondary touchup.
Continue followup with your
plastic surgeon.
Best
wishes...

Rhinoplasty supratip swelling 3 months post-op? PS mentioned steroid injections before removing scar tissue. (photos)

Answers (5)

Answer: Supratip Swelling

Answer: Supratip Swelling

Answer: Postoperative nasal swelling or residual prominence?

Answer: Postoperative nasal swelling or residual prominence?

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Everything you need to know about Rhinoplasty

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Rhinoplasty supratip swelling 3 months post-op? PS mentioned steroid injections before removing scar tissue. (photos)

Answers (5)

Answer: Supratip Swelling

Answer: Supratip Swelling

Answer: Postoperative nasal swelling or residual prominence?

Answer: Postoperative nasal swelling or residual prominence?

Browse related questions

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.