What is lowest effective dose/strength of kenalog for rhinoplasty swelling and scar tissue? (Photo)

Question

I had rhinoplasty 6 years ago to fix a broken nose. I was happy immediately after, but developed a lot of swelling and scar tissue in the tip afterward. I had a revision rhinoplasty in December 2013 and again have swelling and scar tissue in the tip. I am considering kenalog injections, but have experienced indents when injected with kenalog 10 in the past for acne. What strength kenalog should I start with? I have heard of starting with 2.5 - is that the lowest effective strength?

David Reinstadler, MD · Answer

Your situation is a difficult one. Some people are more prone to develop swelling which can become scar tissue. That being said, injectable steroids like kenalog can help with many people. Nasal steroid injections are very different than what you received for acne. For the acne, a very dliute formulation is used because it is injected more superficially. The dermatologist probably used "kenalog-10" but diluted it down to around 1-2mg/cc. In the nose, we want to address the scar tissue which is deeper, so it is injected below the skin. If injected deeply enough, indents are very rare. Usually in the immediate post-operative period, if I feel a patient would benefit from steroid injections, I use about 5mg/cc and inject it deeply into the space with the edema. That being said, small indentations and skin thinning are always risks of steroid injections. Best of luck

Michael Elam, MD (retired) · Answer

Dear Lunatwingirl, I would speak with your surgeon who is proposing the steroid injections and discuss the strength of the injections and concerns you have had with your past experiences. Generally steroid injections to the nose for scar tissue would have been a different dilute then injections to acne scars. Best to discuss your past history with your physician and then come together with the answers to your questions so you may make a very informed decision. Best regards, Michael V. Elam, M.D.

What is lowest effective dose/strength of kenalog for rhinoplasty swelling and scar tissue? (Photo)

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Everything you need to know about Revision Rhinoplasty

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What is lowest effective dose/strength of kenalog for rhinoplasty swelling and scar tissue? (Photo)

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.