Reactive swelling 13 months post op? Would kenalog help? (Photos)

Question

I had primary rhinoplasty 13 months ago. Im mid thick skin id say and i have a history of fillers for 6 years prior to my surgery. My surgeon told me that i had granuloma in my tip and that he used kenalog to the inflammed tissue during the operation. I was advised not to tape but i started taping at 2 months post op as i formed a bump on my bridge . Fast forward to now . If i sleep without tape ,im very swollen when i wake up. To the point i was at 3 months post op. If i tape at night my nose looks decent in the morning. I still have fluctuating swelling but at this point its getting bettet throughout the day and i wont have a completely different nose by the evening ,as was happening 3-4 months ago. I can see that im healing slower than others and maybe it has to do with my filler history and granuloma forming due to them but is it normal for being swollen if i dont tape? I guess that if it was structural deformity,it wouldnt respond to tape at all. So can it be excessively reactive soft tissue? Would kenalog help? Im uploading photos of how my nose looks on days that i tape at night vs on days i dont.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. The final results take at least 1.5 years for the swelling to fully resolve. This can require lots of patience and waiting. Steroid injections performed by your surgeon can be extremely helpful. I usually start steroid injections around 1 to 2 months after surgery and continue as needed. With that being said, the final outcome will really depend on the surgical techniques that your surgeon used during your surgery. I recommend that you maintain close follow up with your surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Eric M. Joseph, MD · Answer

After any fillers are injected in the nose, they are never able to be removed during rhinoplasty surgery. The plane of surgery is deep to the filler, and it is possible that you are having persistent inflammation from what remains. Kenalog may be beneficial, and so may the dissolving enzyme, depending upon your condition. Additionally, you should use retinoic acid (RetinA) on your nose, since you appear to have relatively oily skin, and by clearing that up, you will reduce some of the swelling. Sometimes the tape can cause inflammation as well. Wishing you while moving forward. Sincerely, Dr Joseph

Reactive swelling 13 months post op? Would kenalog help? (Photos)

Answers (2)

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