What can be done to avoid polly beak deformity again after my revision rhinoplasty?

Question

Hello, I had a revision rhinoplasty 10 days ago due to the development of a slight pollybeak deformity and I was unhappy with my nose. Also I have thick skin. I got my cast off 2 days ago and I love how my nose currently looks. My surgeon has advised me to tape my nose and I’ve been doing so. But I’m worried. What if I develop pollybeak again? What can be done to avoid this? I just want to make sure my nose stays nice the way it is. Should i just keep taping for few weeks? Thanks

Oakley Smith, MD, FRCSC · Answer

Glad you are happy thus far with your revision rhinoplasty results-- remember it takes a long time for all of the swelling to resolve, even longer for a revision than a primary.Odds of you having a pollybeak  for the second time is low, since I am sure your surgeon knew that was your concern going in to it. 2 things cause pollybeak, excess dorsal cartilaginous septum cephalic to the actual tip, or scar tissue that develops in the the supratip area. Should a pollybeak be from the cartilaginous septum, taping won't help, really only surgery would correct that. However, since you have thick skin, it is more likely a re-draping issue. I have my patient tape day and night until they return back to work and then every night for at least 6 weeks. In addition, I like to see those patients around 6w post surgery to see how the swelling is resolving and at that time I may offer a kenalog injection to help speed up the swellingng in certain patients. I would recommend continuing to tape as instructed and staying in touch with your surgeon!

Suleyman Tas, MD, FEBOPRAS · Answer

Hello, thank you for your question and provided information. A pollybeak deformity occurs when supratip region leads the tip. You are in early phase of your healing and you have swelling and edema as a part of your healing. Now, you need to finish your healing process and follow up your PS and given instructions.
Best Regards,

Eric M. Joseph, MD · Answer

A true poly beak deformity is when your lower bridge, just above your tip, is higher or more projected then your nasal tip. This is usually a cartilage problem. so if you like the way your nose looks now, you should be very happy moving forward. We do not use taping, however it can't hurt, so you can follow your surgeon's advice. Wishing you a happy recovery. Dr. Joseph.

Farhad Ardesh, MD · Answer

Polly beaks are formed by inadequate hump removal, poor tip support, and scar tissue development above the tip. The most important factor is the surgery that was performed. If you had thick skin I am assuming that your skin was thinned during the procedure. The best thing you can do is follow the advice of your surgeon. Taping may help reduce scar tissue formation above the tip of your nose. Additionally steroid injections may help. Lastly, you must give your nose time to heal during which the skin will become tighter. I wish you the best, Dr. Ardesh

What can be done to avoid polly beak deformity again after my revision rhinoplasty?

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