Solutions for Supratip Fullness After Rhinoplasty?

Question

I had a primary rhinoplasty 2.5 years ago. Supratip fullness was visible immediately after the removal of the cast. Cortisone injections were not given. I was hoping that the deformity will recede with time but it never did. Are there any other solutions to this problem apart from secondary surgery?

Toby Mayer, MD · Answer

You could give a try to cortisone injection 1 time. If this is scar, it may sometimes work. If after 6 weeks, there is no improvement, then you should see a very experienced revision rhinoplasty surgeon. Sometimes the cartilage is a little high and sometimes it is scar tissue.

Michael A. Persky, MD · Answer

Hi Pluie,

	The only non-surgical solution to your supra-tip fullness ("polybeak deformity") is injectable fillers.  Radiesse, Juvederm, Restylane are all temporary fixes.  Silicon-1000 is permanent, which is great when performed properly, a horror story when done wrong.  The best permanent solution is revision surgery.

	Good luck and be well.

	Dr. P

Eric M. Joseph, MD · Answer

I reviewed your profile photo and your concern. I doubt you would benefit from a Kenalog injection to the full area above your tip since all post-surgical swelling is gone 2.5 years after your Rhinoplasty Surgery. It wouldn't hurt to try a dilute steroid injection, but results, if any, would be limited. 

	Your supratip fullness is quite mild, and not terribly distracting. You could consider an Injectable Filler treatment to raise your bridge. This could provide you with a straight (rather than curved) profile, and minimize your concern.

	If raising your bridge is out of the question, then start with a Kenalog injection and leave revision rhinoplasty surgery as a last resort.

	I hope this is helpful for you.

Steven J. Pearlman, MD, FACS · Answer

This sounds like an insulting term but that is the term used in the medical literature to describe supra-tip fullness after rhinoplasty. There are a number of causes and different treatments for each. Thick skin produces more swelling and scar tissue after rhinoplasty. This can be treated by injections after surgery and prevented by removing more cartilage in this areas plus careful taping. Secondly, too much cartilage may have been left on the upper part of the septum or upper lateral cartilages. This is treated by removing the excess cartilage. Lastly, settling of the nasal tip will give the supra-tip a pseudo-hump appearance. Treatment is by strengthening nasal tip projection and prevention by making sure not too much projection is lost when the tip is refined.

Steven Wallach, MD · Answer

A supratip deformity at 2.5 years after surgery will probably only improve with surgery.  This may be due to soft tissue and/or septal cartilage.

Solutions for Supratip Fullness After Rhinoplasty?

Answers (5)