1 year after rhinoplasty, I think I have pollybeak. Shall I try Kenalog injection? (Photo)
Doctor Answers 5
Polly beak deformity and should I have Kenalog injection?
do NOT have a Kenalog injection. This is for thickened skin above the tip. However this is not your problem. It appears that the upper part of your bridge was made too low, the lower half of your bridge what is left too high, and the tip was insufficiently projected. See a very experienced rhinoplasty revision surgeon can show you many examples of his work in noses like yours and worse. Do not rely on imaging.
You have a rather prominent polly beak
Hmm. It's usually doubtful whether Kenalog would help this long after surgery. But it depends a little on what the bulge is made of: if it's firm, like cartilage, there's no chance that the Kenalog will work. You might need a revision rhinoplasty.
First thing I'd do is read the "Web reference" link, just below this post. It contains a section discussing how to tell whether you should allow your primary surgeon to perform your revision.
I usually make a morph when I'm answering questions like this, to show what might be possible for your nose with another operation, but the photos you submitted aren't good enough to make morphs. At the *very* bottom of the Web reference page is a link to instructions on taking photos that are most useful for online consultations like this.
Shall I try Kenalog injection?
Most would agree that your photos do look like a polly-beak, or fullness above the tip of the nose. There can be several causes so we cannot say that Kenalog is the correct approach. Best see your surgeon so he can help determine what has caused things to be as they are.
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Polly Beak Deformity and Kenalog Injections
Kenalog injections in the nose can potentially cause a significant amount of damage. While they are occasionally helpful, one must be very careful with steroid injections in the nose.
I believe the postoperative polly beak deformity is most commonly a result of inadequate nasal tip height and support. This results in a tip that drops below the level of the dorsal septal cartilage. Several techniques are available to increase tip height and support. These techniques include columellar struts, extended columellar struts, tip grafts and tip defining sutures.
Nose treatment after rhinoplasty
Your photos show excess fullness in the nasal tip and supra-tip areas. I think you would do best to follow-up with your rhinoplasty surgeon. An exam of the nose is very important in determining the next best step. Scar tissue can be well-treated with a series of steroid injections, with some surgeons using both a steroid called Kenalog and an anti-scar medication called 5-fluorouracil. Depending on you r exam, you may need steroid injections or further surgery.