Dent in nose s/p steroid injections (1.5 years post-op). Would you suggest filler? (photo)

Question

I had my rhinoplasty 1.5 years ago. My surgeon encouraged me to get steroid injections starting at 2 months post-op. I probably had about 4-5 sessions during the first year. Have since noticed a dent in my nose, which my MD wanted to use filler to correct. Seems like a temporary solution. I have heard steroid can cause denting, but didn’t know back then. Would you suggest filler? I’m upset because my nose looks worse now that it is “fully healed”

Eric M. Joseph, MD · Answer

Sometimes small indentations like you are seeing may appear from 7 to 12 months post-operative after a revision rhinoplasty surgery. Depending on your examination, microdroplet Silikon-1000 injections may be considered for providing Improvement in your nasal profile appearance permanently. I hope this is helpful! Sincerely, Dr Joseph

Gianfranco Frojo, MD · Answer

Using filler in the nose can be devastating if not done correctly. I would recommend asking your surgeon for a potential revision including scar release. The side view appears to show that there is still significant swelling of the tip. Steroids can cause fat / soft tissue atrophy. I do not recommend performing these more than 2-3 times total. I would recommend finding a plastic surgeon with at least 6-7 years of training in actual plastic surgery.

Lexie Wang, MD · Answer

Hi daisies. I'm sorry this happened to you - this is why I tell patients that steroid injections are actually quite powerful and can sometimes cause dents! In terms of what you can do now, the easiest would be to do filler but if you are wanting a more permanent option it would involve another surgery to put something there. I would discuss with your surgeon.

Donald Groves, MD · Answer

Hello and thank you for your question. After rhinoplasty (nasal surgery), the nose can become REALLY swollen, and this swelling can take a LONG TIME to resolve (up to 1-2 years to fully resolve). To help speed up the process, sometimes we inject steroids into certain spots, as your surgeon did. Sometimes there are focal asymmetries and depressions which become visible over time- this can happen with or without the use of steroids. Like your surgeon, my preference is to address these with dermal fillers- they are a quick, easy, minimally invasive, and very effective method for smoothing out any focal indentations to make the nose more symmetric and improve the overall rhinoplasty result. The alternative is a full blown revision surgery, which is much more invasive and would be overkill to address such a focal area of concern, especially if you are happy with the remainder of the nose and the swelling has already almost fully resolved. I hope this helps! 
Best, 
Dr. Donald Groves 
Plastic Surgeon

Gary M. Horndeski, MD · Answer

You can try fillers but they will be temporary.  The other alternative is a revision rhinoplasty to straighten the dorsum.

Best Wishes,

Gary Horndeski, M.D.

Andrew Miller, MD · Answer

The dent that you have now doesn't look like the usual place to inject steroids. It may be result of general swelling going down. Either way, a filler is a great and easy way to make the bridge smoother. If the temporary filler works well, when it goes down, silicone can be used to give a permanent result. Be sure to see an expert injector for consultation.

David M. Kowalczyk, MD, MBA, FACS · Answer

Great question. Filler is a temporary solution and it's not without risk. It can help camouflage dents. You're correct that too many steroid injections can cause skin damage and asymmetries. There are options in the form of revision which can be targeted to your specific concerns. I would discuss the pros and cons with your surgeon regarding filler. Hope this helps.

Dent in nose s/p steroid injections (1.5 years post-op). Would you suggest filler? (photo)

Answers (7)

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