Supratip swelling at 3 months - is it time for a steroid injection? Or leave it be? Continue taping or no?

Question

I had my tip reduced in a revision rhinoplasty 3 months ago, with significant supratip swelling since. I'm not sure if it has improved or not. Would you call this a pollybeak deformity? I tape every night still - should I stop? Should I seek a steroid injection to resolve it, or should I continue to wait and hope it gets better? What's my window for steroid injections? My surgeon is in Istanbul so I'm hoping to find someone in New York to inject it; who would you recommend? What's the fee range?

Ronald Schuster, MD · Answer

It looks like you have some supra tip swelling but I would not call this a polly beak deformity. It might be due to somescar tissue, in which case kenalog injsections done carefully could help. It could also be due to the dorsal septum being left a little high. You need to see an exprienced rhinoplasty surgeon for an exam and advise. Good luck.

Jonathan Kulbersh, MD · Answer

Thanks for the question and photos. Swelling after rhinoplasty can persist for much longer than three months - sometimes it does not fully subside for up to one year. That said, you might be a good candidate for a steroid injection to help manage your swelling, but that would need to be determined through an in-person consultation. I encourage you to find a board-certified plastic surgeon here in the states that can give you a full assessment and make recommendations to enhance your recovery process.

Evan Ransom, MD, FACS · Answer

Thank you for the question. At this point in your post-operative healing, taping is not likely to be really helpful. Have you started and tip massage? It sounds silly, but when properly done, this can be super helpful in alleviating small areas of persistent swelling. Adding a tiny steroid shot can also be helpful, but this is optional and should be discussed with your surgeon. Best of luck and take care!

Jonathan Pontell, MD, FACS · Answer

Hi and thanks for your question and photos.  Yes, I would do a steroid injection to help decrease the fullness in your supratip.  I also believe that taping of the supratip at night time is helpful.  Good luck.  Dr. Pontell

J. Phillip Garcia, MD, FACS · Answer

It is unlikely that you will have a "pollybeak deformity" after your rhinoplasty.  This is especially true if the tip was the only area addressed during your surgery as you state.  This is likely simple postoperative swelling that will go away with time.  Steroid injections are a great option to reduce swelling because there is very little down side.  Wait until your surgeon returns and schedule a visit with him so that you can find a course of action. Best of luck.

Eric M. Joseph, MD · Answer

Based on your profile photos, your supratip swelling appears mild, and this may disappear with time. If you were our patient, I would consider offering a dilute steroid injection and re-evaluate a month later, depending on your examination. We do not recommend chronic nasal taping for our patients. Hope this helps. Dr Joseph

Pejman Aflaki, MD · Answer

Hello and thank you for the question. There is some fullness in the supra-tip area, which could be from scar tissue or underlying cartilaginous framework. An in-person examination would help distinguishing between the two. Steroid injection can help. You should see your surgeon for an evaluation and guidance. Best

Donald B. Yoo, MD, FACS · Answer

Hello,
I would recommend following up with your surgeon as your nose heals to ensure the best outcome.
Good luck! 
@drdonyoo @asianrhinoplasty

William Townley, MD, FRCS(Plast) · Answer

Hi there. Thank you for your post. At 3 months, the swelling is likely to be scar tissue related and it is the right time for a steroid injection in my opinion - before the scar becomes too fixed. However, the shape may also just reflect the underlying structure that was created during surgery.

Richard Balikian, MD · Answer

This does not appear to be a pollybeak deformity. Taping at this point will probably not have much effect. A steroid shot may still be of use three months post surgery. Good luck

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