Would a steroid shot help for pollybeak from a revision rhinoplasty?

Hi CSmitty-

Steroid injections to the supra-tip area can help decrease soft tissue inflammation during the healing process up to several months after the surgery. Unless you have very thick skin which can be associated with longer than usual post-operative tip swelling, steroid injections may not be of benefit. Your rhinoplasty surgeon should be able to make this determination.

Sincerely,

Tom Kaniff

This is a safe option and effective - if the pollybeak is soft tissue and scar related and there is good tip support.  Otherwise a revision rhinoplasty with structural grafting would be needed

It is unlikely that after several years steroid injections will help a pollybeak.  Steriods are useful in the immediate post-operative period to reduce swelling and perhaps scar tissue formation, but likely don't have any lasting effect with the progression of time. 

I agree with the others, such that you have nothing to lose by trying.  Two years after a revision surgery the nasal structure is probably fairly established, but your only other alternative is a second revision surgery to remove what would then be clearly established as dorsal cartilaginous septum.  You would know within a month, so you are hardly delaying further treatment if you just give it a try.

I read your concern. If your bridge is too high such that you have a "polly beak", Revision Rhinoplasty may be necessary to improve the appearance of your nose. Posting a profile photo would help us advise you.

Steroid injections are useful in reducing post-op swelling usually within the first year after your rhinoplasty Surgery.

Regards from NJ.

Having an injection of either a steroid or 5-FU to combat excessive scar tissue is a possibility, although it may not help very much if there's a large residual cartilage component.

Examining your nose in person would allow for a better assessment of your chances of improvement with an injection. Residual cartilage would have to be surgically removed to improve that aspect.

There are two types of pollybeak deformity- soft tissue and hard tissue. Soft tissue pollybeak is related to scaring in the supratip region following rhinoplasty.  This can be improved by steroid injection in both the short term as well as in the long run.  You can see improvement even years after the rhinoplasty.  Hard tissue pollybeak is related to excessive cartilage in the supratip region. This usually occurs when a hump is taken down but the cartilage in the supratip is left. In these cases, steroids will not help.  Revision surgery will be necessary to remove the excessive cartilage.  In your case, it sounds like revision surgery may be needed, and that steroid injections will not help.  In fact, using steroid in this region when not beneficial can make future surgery more challenging and potentially more risky. 

Steroids can help a pollybeak deformity, but by your description, and by the fact that you are 2 years out from the procedure, I doubt a steroid injection would do much for you. I have seen steroid injections do a wonderful job of improving a pollybeak deformity up to about 6 months after the procedure, but at 2 years, I think what you see is something that will require another revision rhinoplasty.

Andrew C. Campbell, M.D.

Board Certified Facial Plastic Surgeon

Low-dose steroid injections after rhinoplasty can be helpful to reduce postoperative edema and/or early scar tissue formation.  They are most effective within the first 12 months after surgery and/or trauma.  At this point, steroid injection success would be low, but certainly could be done as an intial step before considering further surgery.  It should be noted that steroid injections should be used with caution, because they can produce tissue atrophy if used at larger doses or multiple injections are used.  A careful evaluation by your surgeon, or seeking out a second opinion would be the best first step to determine if the injection(s) would be helpful.  Best wishes.

Michael P. Vincent, MD, FACS

Steroids do work for pollybeak in some cases. However there are other causes. Your note indicates it is 3+ centimeters high; do you mean millimeters? 1cm=10mm. Post some photos and I will share my opinion. Good luck.