Will Kenalog injections work to treat scar tissue after revision rhinoplasty?

If residual swelling or scar tissue is the cause of your tip being round and droopy, Kenalog injections should help. Kenalog is a steroid which can speed up the resolution of edema, or swelling, in the nose. However, it should be used judiciously and only in the right patients, as overuse can result in thinning of the skin of the nose and in extreme cases, problems with the blood supply to the nasal skin. The swelling could also be related to inflammation around the silicone graft in your nose. Careful physical examination would provide more clues regarding the cause of your issues and whether or not you would require another revision.  Best wishes,  Dr. Mehta

Be cautious about kenalog injections in the tip of your nose with a silicone implant.  It works great to soften and thin scar tissue, but it will also thin the skin envelope.  Thin skin and synthetic implant is a poor combination, and will increase your risk of the implant extruding.  Share your concerns with your surgeon, as he/she will be your best resource.   

Dear revision rhinoplasty patient from San Diego,
If I understand you correctly, after your second rhinoplasty with silicone graft everything was going great until recently that you have noticed swelling. This could be a sign of infection associated with nasal graft. Kenalog injection would be contraindicated in that case. Please visit your plastic surgeon for evaluation. Good luck
 

The utility of kenalog injection to the nasal tip is overcome by the detriment of graft resorption and atrophy of hte native structure of the nose.  In my practice, I would advise against kenalog injection to the nose in your case. 

Wounds heal by scarring. When there is too much, it's a problem. If the problem is really a ball of scar under the skin and not a structural issue or the implant, then steroid injections over a period of time like a year could help.

It is very common after revision rhinoplasty and even primary rhinoplasty for the tip of the nose to develop scar tissue especially in thicker skinned noses. Kenalog injections into that area can help to diminish the scar tissue and treatment may be needed for a year or more. I hope this information helps.

I would be cautious about injecting kenalog around a silicone implant. You risk the potential for skin atrophy, breakdown, ulceration as well as implant exposure and extrusion. Discuss this with your surgeon and perhaps obtain a second opinion

 In our practice we use Kenalog injections in the tip and supratip area of the nose routinely in an attempt to reduce swelling and edema in the tip and supratip  area of the nose. Kenalog injections work by melting scar tissue and reducing lymphatic edema that gets trapped in this area of the nose. Depending upon the skin type more than one  injection may be necessary. Dark  and thick oily sebaceous skinned individuals tend to need more shots than light-skinned individuals. Blenderm tape is also helpful when used at night across the supratip area of the nose to prevent fluid retention from accumulating

Swelling can vary drastically after revision rhinoplasty.  I sometimes use kenalog to reduce overall tip edema or supratip swelling.  Your slightly asymmetric swelling does not bother me as much as the fact that you have an alloplastic implant in your nose.  I would see your surgeon because the implant may have moved, it may be developing surrounding scar tissue, it might be creating a reaction in the surrounding tissue, etc.

After a revision rhinoplasty, it may be possible to use a small injection of a steroid such as Kenalog to calm the inflammatory process and treat scar tissue. However, keep in mind that this is a very strong medication that can have serious side effects to the overlying skin. For this reason, Kenalog should be used in tiny amounts and only by a very experienced plastic surgeon.