Male, 5 months post revision, am I developing a polly beak or swelling? Should I get steroid injections? (photo)

Question

I am 5 months postop from a revision rhinoplasty. I do not know whether I am developing a pollybeak and if I should get some steroid injections, or is it just swelling. Thank you for your help.

Ivan Wayne, MD · Answer

There appears to be some disagreement among the surgeons that have answered your questions and I may be able clarify the situation. A polly beak is undesired fullness in the area of the nose right above the tip, looking sort of like a parrot’s beak. Most surgeons only consider a polly beak only when the fullness is the result of scar tissue or incompletely removed cartilage. In your case I would say that you have fullness in the supratip area. At 5 months in a revision case it is most likely due to swelling. Male noses take longer to heal as do revision noses. You will have to see how your nose heals over time. Some surgeons believe in injecting kenalog in these situations to prevent scar tissue from forming but I would leave that option up to your surgeon.

Kenneth Hughes, MD · Answer

No, that deformity is not present.  There may be residual swelling, but I certainly would not reoperate on that result. 

	 

	 

	 

	Kenneth Hughes, MD Los Angeles, CA

Stephen Prendiville, MD · Answer

Based on the photo shown, there is no evidence of a pollybeak deformity. A "pollybeak deformity" is abnormal postoperative supratip fullness, generally related to scar tissue and/or inadequate reduction of a high lower dorsal septum. However, at 5 months, you are expected to have some degree of swelling, which the photo appears to show. Whether or not you should have steroid injections is up to your operating Surgeon. Remember, that most of us don't make a final judgment on results for at least 9 months and usually a year.

Steven Wallach, MD · Answer

Doesn't look like you have a polly beak to me.  But you probably have some swelling still. Give it time to heal.

Robert Brobst, MD · Answer

Thank you for sharing your concerns and images. At 5 months swelling is still a problem when making an evaluation of results. You appear to still have some fullness in the radix and tip that should continue to improve with a tincture of time. Be patient and share your concerns with your surgeon. He is the best judge of whether a steroid injection might provide benefit based on what he can palpate and his insights from the maneuvers performed during the surgical procedure. I hope this helps. Take care.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

	Yes you have a slight polly beak deformity. This may respond to steroid injection. I would wait a full year.

	Best,

	Dr.S.

Male, 5 months post revision, am I developing a polly beak or swelling? Should I get steroid injections? (photo)

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