Steriod Injection After Revision Rhinoplasty Cause Atrophy?

Question

I had a steriod injection following revision rhinoplasty to help with some scar tissue formation after noticing a "bump" on the bridge of my nose at 6 weeks postop. Since then, I've developed slight atrophy in the area of injection and my skin appears to have less color in that area. I'm about 8 weeks postop now. How soon will I notice a difference in pigment again and will the tissue rebuild in my nose at all?

Houtan Chaboki, MD · Answer

Steroid injections after rhinoplasty, primary or revision, are used by many plastic surgeons to help reduce scarring or swelling in appropriate patients. Steroids can occasionally work too well and cause too much nose thinning. Fortunately, the tissue may even out gradually over time. Results from steroid injections will vary from patient to patient.

	Only your rhinoplasty surgeon can best answer your specific questions. Best of luck.

	Dr. Chaboki

John M. Hilinski, MD · Answer

This type of adverse response is certainly seen in some cases. However, I have seen patients get this type of initial response to the steroid with subsequent rebound of the skin to where it looks fairly normal again. In other cases, you will need to add back some volume to restore a more natural contour. In cases where the pigment has been lost, it can be a more permanent change, unfortunately.

David A. F. Ellis, MD · Answer

I will often mix steroid with 5 F U (50/50) to stop depigmentation in the area of the skin.  It should be injected under the skin in order to avoid the depigmentation.  Regrowth of collagen in the skin where the atrophy is may take a couple of years. You should keep follow up appointments with your surgeon.

	 

	Dr. David  Ellis

	Toronto Facial Plastic Surgeon

	artoffacialsurgery.com

Steven Wallach, MD · Answer

That is why I am not a big fan of steroid injections into the nose. Yes, you can get atrophy and you can get hypopigmentation which may not get better.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

	Steroid injections work great if the right dose and amount is used. However, it can cause atrophy and depigmentation. This may or may not reslove, only time will tell.

	Best,

	Dr.S.

Daniel Greenwald, MD (in memoriam) · Answer

Steroids can do this, and only time will tell if things will get any better. See you doctor regularly at 6 week intervals and get photos taken to document the trend. When things stop evolving assess the result. If there is still a visual distraction consider a little make-up. If there is a divot (contour depression) you may be a candidate for an injection with dermal fillers. If you want to see how the fillers work without committing yourself forever use Restylane (it will resorb over 8-20 months). Artefill is permanent but requires an allergy skin test before use. Radiesse also works well and should last in that location 1-3 years. Fillers are very popular and the results are entirely dependent on who does the injection.

Steriod Injection After Revision Rhinoplasty Cause Atrophy?

Answers (6)

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