1 month post rhinoplasty supratip swelling. Alternative options to cortisone/steroids? (photos)

Question

I had closed rhinoplasty a month ago, my skin is thick and oily. I´m developing a pollybeak but i'm not a candidate for cortisone (incipient bilateral cataract). Taping seemed to work but I'm afraid it was working better the 1st days. My PS suggested massages only. I'm depressed. Do i have any other options? Hyperbaric therapy? Ultrasound? Thank you!

Gerald Minniti, MD, FACS · Answer

Hello,Although you aren't a candidate for systemic cortisone, local injection would not affect your lens. Regardless, it would not help you, nor would massage, ultrasound, or hyperbaric O2. Your septum is too short and underprojecting, and your tip cartilage complex lacks structural integrity, shape, and projection. You should heal and find a revision rhinoplasty specialist (ABPS certified/ASAPS member surgeon or an AAFPRS equivalent). Best of luck!

Bradford A. Bader, MD · Answer

It is still early in your healing period but I'm worried that you will not see much improvement. Patients with thick skin often need very strong structural support of the tip complex to project the nose and prevent deprojection and pollybeak formation. This tip projection should be evident at this stage of your recovery. Keep in touch with your surgeon for direction but a revision might be necessary.

Ziyad Hammoudeh, MD · Answer

At only 1 month postop from rhinoplasty, you
are still very early in your recovery with a tremendous amount of swelling in your nose.  The
swelling will resolve in a progressive fashion over months in the
direction of gravity: the upper third will resolve in about 3 months, the
middle third in about 6 months, and the tip in 9 - 12 months.  In
general, it takes a full year to see the final result.  It is not uncommon
to be frustrated at this point in your recovery.  It
is too early to judge the appearance at this point, as swelling likely
is a big component of what you see.  Based on your photos, it appears that the taping helped to reduce swelling the supratip area a great deal.  That is a good sign that the appearance will look great once the swelling resolves.  I would recommend following up
with your rhinoplasty surgeon closely to discuss any concerns you may have throughout
the healing process.  Good communication and rapport between patient and
surgeon both before and after surgery is very important.  Best of luck in your recovery!
Ziyad Hammoudeh, MD

Jon Kurkjian, MD · Answer

Thank you for your question. 
With any nasal surgery, the name of the game is patience. At one week, we would expect you to have quite a bit of swelling and bruising still noticeable and may have trouble breathing out of one or both nostrils. By the end of two weeks, typically, you will still be swollen but look more like you have a bad cold, rather than post surgical. Swelling can take up to a year to be completely gone, however, by 9 weeks you will look very good and should see big difference from your pre-op pics.

David R. Broadway, MD, FACS · Answer

Swelling after rhinoplasty surgery (especially an open procedure) is common.  It can take several months for the final result to be seen.   You are still in the early healing phase.

Massage and taping should help the healing process, but patience is also needed.  
I recommend that you continue to work closely with your plastic surgeon.  He/She should be a source of reassurance and support as you continue to heal and improve.

Paul N. Afrooz, MD · Answer

Supratip swelling is not an uncommon problem after rhinoplasty.  If done properly and consistently, taping is a very effective way to control and reduce supratip swelling in the long term.  Swelling can fluctuate for several months after a rhinoplasty, and you must be patient during your healing.  Just because it seemed to work better initially does not mean you should stop.  I would discuss this with your surgeon, and keep in mind that taping is not an overnight fix.  However, it is effective and carries minimal risk.

1 month post rhinoplasty supratip swelling. Alternative options to cortisone/steroids? (photos)

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