Nose tip is a strange shape and feels very hard. Is this scar tissue? And if so will steroid injections help? (Photos)

Question

Female, procedure done at 18 years old almost 2 1/2 years post op. Currently 20. I loved my results and as it healed i noticed my tip became a strange shape. The bottom of the tip feels very hard not sure if this is scar tissue and if it is would sterioid injection potentially remove it? It’s the onky thing I dislike about my nose

Semih Yildiz, MD, FEBOPRAS · Answer

The three close side and oblique photos show a localized angular contour at the tip or supratip, but they do not reveal whether it comes from thick scar, a cartilage graft, suture, asymmetrical tip cartilage, or skin-level change. At 2.5 years, ordinary postoperative swelling should be largely settled, and a distinctly hard area is often cartilage or graft-related rather than injectable soft scar.

Steroid can sometimes soften a confirmed area of thick, pliable scar tissue, but it will not dissolve cartilage or reposition a graft. Injecting the wrong problem can cause skin thinning, pigment change, visible vessels, or a permanent depression. Have your operating surgeon palpate the area and compare current photographs with the early result; if the finding is structural and bothersome, a small revision may be discussed. Do not proceed with steroid treatment until an in-person examination identifies exactly what is creating the hardness and shape.

Eric M. Joseph, MD · Answer

I do not believe that steroid injections would be helpful at this stage of the game. We utilize steroid injections when there is super tip swelling only. If you are not happy with your outcome, please consider discussing this with your surgeon, or getting a second opinion from another reputable rhinoplasty specialist. Wishing you well moving forward.

Kyle Kimura, MD · Answer

Great question and thank you for providing photos! 
It is a bit challenging to determine based on photos alone, but the change in shape of the tip can come from a subtle dropping of the tip over tip called tip ptosis. It may be that the firm part is the cartilage in a new, lower position where you can now feel it. It is also possible you may be able to palpate any cartilage grafts if they were placed. As always, I think the best place to start is to let your rhinoplasty surgeon know your concerns as they will know better than anyone else would it could possibly represent.
Hope this helps and best of luck!Kyle Kimura, MD

Nose tip is a strange shape and feels very hard. Is this scar tissue? And if so will steroid injections help? (Photos)

Answers (3)

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