Can I find a surgeon who will administer kenalog injections for me after rhinoplasty?

Question

My surgeon refuses to use kenalog injections. I'm most comfortable with a revision surgeon who absolutely refuses to use kenalog injections and never bothered to learn to use them in his years of practice. He also lives in another state. Why can't I get a another surgeon to administer kenalog for me, so long as they know what's in my nose and my date of surgery? How long would I use a medrol dosepak as a substitute for this?

William Portuese, MD · Answer

Much more information is needed, such as a full set of facial photographs, and a physical exam to determine the thickness of your skin.  The swelling of the tip of your nose will also be dependent  upon the thickness of the skin, and which surgical techniques are performed.  Rhinoplasty involves shaping the cartilage and bone structure framework of the nose, while steroid shots manage the soft tissue skin envelope over the framework of the nose.  The concentration, timing, and placement of the steroid shots are very important, when needed. Not all patients require steroid shots

Charles H. Thorne, MD · Answer

Kenalog or Triamcinalone is an insoluble steroid that can decrease swelling. It is not uncommon to inject very small amounts into the nasal tip or supratip after rhinoplasty. Steroid injection is NOT totally benign, however, since it will cause atrophy of the tissues and discoloration of the skin. A Medrol dose pack requires taking steroids orally so the effects are systemic, not just confined to the nose. There are rare but significant complications that have been reported. It is possible that your surgeon believes that there is no further swelling to remove and that, as a result, steroid injection won’t add anything to your situation. And it’s true that Kenalog injection has never turned a bad result into a good result. I would just caution you regarding too many steroid injections.

Can I find a surgeon who will administer kenalog injections for me after rhinoplasty?

Answers (2)

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