Steroid Injections Before Revision Rhinoplasty

What kind, amount, and concentration of steroids are injected in cases of excess swelling after Rhinoplasty? I only am asking this because I am considering a 2nd rhinoplasty after my previous doctor messed up my nose by doing things in my surgery. If I had researched, I would have known what were not normally done in rhinoplasty and I could have prevented having to now have a second operation.

I just want to know that everything is done right. Also, I have very thick, oily skin that stays swollen forever and has broken out horribly for 4 months after my last surgery, due to swelling putting pressure on oil glands.

Doctor Answers 3

Thick Skin Equals Tough Rhinoplasty

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As Dr. Rand pointed out, thick oily skin is a very challenging problem in Rhinoplasty. Understanding this point is key to understanding that Rhinoplasty offers patients a range of results which are limited by thick skin. It is very difficult to obtain great tip definition, swelling tends to last longer, and results tend to be less impressive in virtually any Rhinoplasty surgeon's hands. It is important to understand that the nose is responsible for 80% of our breathing; the surgeon's first job in Rhinoplasty is to preserve or improve nasal function. Therefore, the cartilaginous structures that give your tip and middle vault shape must be respected and not over-resected. The temptation in Rhinoplasty where a patient has thick skin is to aggressively reduce; the reality is that only so much tissue can be removed and a thick skin soft tissue envelope tends to mask results.

Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews

Be careful in having anti-inflammatory injections into the nose

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You have to be very careful injecting any anti-inflammatory steroids into the nose. You may be better off with the standard Solumedrol dose pack taken orally for about 5 days. Injections have to be small or dilute with 4 or more weeks between injections because if you over do it which is quite easy to do you will end up with dents and skin damage that may be impossible to fix. If you have or are developing a rhinophyma the solution is a bit more complicated.

Most rhinoplasty procedures are performed on the architectural structures within the nose. The surgeon hopes and expects the skin to shrink wrap around the architecture so you have a good result after surgery. Thick oily skin doesn't shrink wrap as well. If you have a concurrent skin problem or develop one after surgery such as a rhinophyma the treatment has to involve the skin as well.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Unhappy rhinoplasty

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It sounds as though with your skin envelope you will never have a great rhinoplasty no matter who is doing it. Patients with think oily skin cannot have a well defined result the same way as a person with thinner skin. Make sure before you do anything that your new doctor clearly sets your expectations at an appropriate level or you will be in for another disappointment.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.