Thick scar tissue affecting the contour of my nose, will I need steroid injections? (Photos)

Question

I am at 7 weeks past surgery and have noticed my left nostril more swollen and thicker scarring tissue that is causing fullness near the tip of my left nostril that makes the contour look undefined, I know I should be patient but seems like it isn’t looking better. Would I need steroid injections to help with this?

Jacob Sedgh, MD · Answer

In the first few months following a rhinoplasty, injection of steroid (Kenalog) has shown to have a positive effect in softening and thinning of the scar, a practice often targeting areas of interest around the tip. However, it is best to consult the primary surgeon as there are nuances with details of the surgery, what grafts or implants have potentially been used, preoperative and intraoperative findings...

Jacqueline T. Cheng, MD · Answer

Hi, and thank you for your question. Post-rhinoplasty, steroid (Kenalog) injections often help to thin and minimize scar tissue and reduce inflammation and swelling. There are limits to this treatment, however, and it won’t necessarily change contour lines resultant from thicker skin or cartilage. Further, if cartilage or other grafts were part of your surgery, then steroid injections may not address your concerns. Also, since this area of the nose typically takes longest to heal, your final outcome simply may not be ascertainable at this stage. Schedule a follow-up with the board-certified facial plastic surgeon who performed your procedure, share your concerns, and discuss possible next steps. Good luck!
- Jacqueline T. Cheng, MD

Ronald J. Edelson, MD · Answer

I commonly use steroid injections in the nasal tip to help thin out the skin and obtain a refined appearance.  This is a common practice and I agree it is worth doing in your case.

Gerald Minniti, MD, FACS · Answer

Hello,The high quality photos (thank you, that is rare) don't indicate amorphous scar or swelling.  What you are describing looks like the actual tip cartilage, and its affect on the alar rim. Please have a discussion with your surgeon. Best of luck!

Evan Ransom, MD, FACS · Answer

Thank you for the great question. Yes, small, carefully placed doses of steroid (typically Kenalog, aka triamcinolone) can be helpful for scar tissue and persistant inflammation after rhinoplasty. It is important to remember that this won't make huge changes in the nasal contour. If you have overly thick skin or cartilages that are too large, a revision surgery would be a better option. Take care and best of luck!

William Portuese, MD · Answer

Its always best to ask your operative surgeon about placement of steroid shots into the tip of the nose. In our experience,  thick skin in the tip of the nose does tend to take long to heal and does require steroid shots in the first few months after the procedure. In addition to shots, taping can also be beneficial.

Thick scar tissue affecting the contour of my nose, will I need steroid injections? (Photos)

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