What Should I Do About my Swelling or Scar Tissue from my Rhinoplasty?

I had an open rhinoplasty over a year and a half ago. It is still swollen, or maybe scar tissue. I can't tell, but I know this should not be the final result. I went to my plastic surgeon's office and talked to the nurse about it a couple months ago. She said it was normal and said it would be done in 18 months and there was nothing else to be done. 19 months out and it is still the same. Would kenalog injections work? I don't want more surgery because I don't want to be more swollen.

Doctor Answers 8

Kenalog injections improve contour irregularities after rhinoplasty

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Carefully performed kenalog injections may still improve any contour irregularities due to post-operative scar tissue following your rhinoplasty.  I think this is something worth considering to address your concerns. 

Swelling or Scar Tissue after Rhinoplasty

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Any  changes 19 months after rhinoplasty will be very subtle. I suggest you talk to the surgeon, not just the nurse, to evaluate your result and discuss treatment alternatives.  A second opinion would be helpful at this time of uncertainty.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Options a year and a half after rhinoplasty

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After a year of healing, if you are unhappy with your rhinoplasty result, it is futile to point to scar tissue, and Kenalog is not an option that will lead to a safe and lasting result. Your nose can improve slightly over another year, however if you are disappointed, surgical revision is the only real option.

Best of luck,


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Persistant Swelling Year and Half After Open Rhinoplasty

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Difficult to answer your question without seeing your nose.  Kenalog injections into the nose can result in decreased swelling, but must be used judiciously and properly or adverse results may occur.  It sounds as if you may consider revision rhinoplasty in the future when you are ready.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Rhinoplasty results take ! year.

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Since it is 19 months, your nose is the nose you will have. Without seeing photos, it is hard to say what you "need". Kenalog injections are for the swelling just above the tip and may not help. Surgery is your only other alternative.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Post Rhinoplasty Swelling

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Tip swelling after rhinoplasty is very common. In patients with thick skin or abnormal swelling, small monthly injections  of steroids such as Kenalog maybe helpful in decreasing the swelling and shrinking the normal scar tissue that fills the supratip space.

At 12 months, 90% of the swelling is usually resolved. Minor changes will continue into the future.

You should be followed by your surgeon, not his nurse. Only the surgeon who has operated on you and can examine your nose can determine whether steroid injections would be useful or the need for a revision rhinoplasty. 5-10 % of rhinoplasties require a revision surgery.

See your surgeon for follow up.

Good luck,

Richard L. Dolsky MD

Richard L. Dolsky, MD (retired)
Philadelphia Plastic Surgeon

Swelling after open rhinoplasty

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Persistent swelling in the nasal tip is a common problem after open rhinoplasty. However, 18 months out, you should be very close to a final result from the nose job. It's unlikely that the nose will change significantly from the way it looks at this time.

I suggest you visit your plastic surgeon to discuss your concerns. If you don't want a revision operation, steroid injections are the only other choice that may be beneficial. I have found careful steroid injections to be helpful in reducing post surgical scar tissue in many of my patients. I prefer injecting small amounts at monthly intervals.

Maurice M. Khosh, MD
New York Facial Plastic Surgeon

Most likely scar tissue after Open Rhinoplasty

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 It's most likely scar tissue 19 months after the Open Rhinoplasty and won't really change from here.  Kenalog typically is useful to stop the swelling from turning into scar tissue or not allowing the scar tissue to mature...which at 19 months it is IMHO.  You can try the kenalog but it might create indentations that are unlikely to go away at this late stage after your Rhinoplasty.

Sounds like you might have to live with the result until you hate it enough to have a Revision Rhinoplasty which is also a risk and no guarantee that the scar tissue wont return...unless you didn't do daily nasal massage and kenaolg injections the first 6 months...to lessen scar formation.  In that case, it's worth a try...if you hate the look of your current nose enough.  Hope this helps.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.