Will steroid injections work on old scar tissue under the skin of the nose 7 years post revision rhinoplasty?

Question

Hello, I had rhinoplasty for the second time 7 years ago. I have thick skin so the scar tissue has really built up. I am now reading about steriod injections for scar tissue. Since I had it done 7 years ago will it make a difference if I have it done now? Thank you kindly

Nelson Lee Novick, MD · Answer

The nonsurgical use of intralesional steroids, such as triamcinolone acetonide suspension, 5-FU and even intralesional hyaluronidase (which is typically used these days for dissolving hyaluronic acid fillers) can be helpful for shrinking scars, particularly elevated scars, including old, so-called fully "matured" scars. Naturally without the benefit of an in-person examination that allows for palpation and manipulation of the skin, I can only mention these approaches in a general way. You would be wise to seek consultation by a board certified aesthetic physician before embarking on a third nasal surgery. Best of luck to you.

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  It really depends on the exact nature of the scar.  Sometimes a surgical scar revision is better for a rhinoplasty scar.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Will steroid injections work on old scar tissue under the skin of the nose 7 years post revision rhinoplasty?

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