What is the Time Frame for Steroid Injections on Tip After Rhinoplasty?

I had a second open rhinoplasty 5 weeks ago - first one was closed. Now the tip looks different from the rest of the nose: so swollen, it looks like two noses were merged together. I understand that is possible to have accumulated scar tissue after the first rhino. Hence it's not swollen and it might never go away.

But steroid shots could fix this without additional surgery. I would rather wait the required 3-6 months and and only after use the shots. My question: is there a deadline for using the steroid shot or after a certain period is it too late? Thanks.

Doctor Answers 11

Steroid injections of the nose after rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The answer is different in different offices, since there is no data that directly answers your question. My opinion is that kenalog (steroid) injections bring down swelling and limit the deposition of scar tissue. If overdone, they can thin the skin/soft tissue envelope and cause distracting depressions, or alterations in the quality and drape of the skin. But in my experience that is rare.

I consider an injection as early as one week post op, typically in cases where its a revision and I know the patient has a tendency to heal with a lot of scar tissue or skin thickness.

More commonly I wait until one month post op. By that time some of the swelling has resolved and it's easier to see where a steroid injection has merit.

I also have four different concentrations for the steroid we inject, in order to further control how aggressively we are manipulating the healing process. So because of that, I use it quite a bit in my practice. I have to back that by noting more than one of the leading educators/surgeons in the rhino world use kenalog on every rhinoplasty one month post op.

Two things specific to your situation. One, revision rhinoplasty always swells longer than the original rhinoplasty. Two, open rhino swells more than endonasal rhino. And the tip (or infratip lobule) always holds the swelling the longest

Madison Facial Plastic Surgeon
4.7 out of 5 stars 15 reviews

There is no time limit for steroid injections after rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I think injections with very dilute kenalog K10 can be helpful with post operative swelling following a rhinoplasty. It needs to be injected deep below the skin in the soft tissue of the supratip (just above the point of the tip). I like to wait 3 months before injecting for the nose settle down and bulk of the swelling to subside.

Ivan Wayne, MD
Oklahoma City Facial Plastic Surgeon
5.0 out of 5 stars 65 reviews

What is the time frame for steroid injections on tip after rhinoplasty?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Swelling after rhinoplasty particularly in the nasal tip is normal and is a part of normal healing. There is little to stop the tip of your nose swelling as only a small volume of swelling can be visible in this area of the nose.
A combination of factors will help with reducing swelling. Firstly, sleeping with your head slightly elevated above the rest of your body. Secondly, the use of taping compression of your nose soon after surgery. Thirdly, the use of anti-inflammatory treatments to the tip of the nose, including steroids. Dr. De Silva advocates the use of such medicine in most patients to speed up the resolution of swelling and ensure faster recovery after surgery. Although the final results of rhinoplasty can be more than one year after surgery, the use of anti-inflammatories can shorten this period considerably. Patients with thicker skin which includes certain ethnicities and ethnic rhinoplasty, may benefit from more than one anti-inflammatory treatment. Dr. De Silva routinely uses steroids with other anti-inflammatory medications to speed up the resolution after surgery as part of the procedure to give every patient the best possible result. 
There is no scientific data that supports timing of steroid injections after rhinoplasty. Some surgeons prefer to use steroid injections soon after surgery, others prefer to use steroid treatments months after surgery. As with every treatment the potential advantages of the treatment including reducing swelling and speeding up recovery need to be evaluated against an individuals potentials risks. As with every medication there is always a small risk of side effects and anti-inflammatory medications are not suitable for every patient.

Tip swelling after secondary rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You need to give months, not 5 weeks. The tip in an open, and especially secondary rhinoplasty takes a very long time- up to two years for the swelling to come down. Steroid injections risk thinning the nose, creating dialated blood vessles and perhaps weakening of the cartilege. Be patient

Steroid time frame for injection after rhinoplasty (nose job)

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Steroid time frames for injection clearly vary with surgeon and their personal preferences following surgery. I generally consider these beginning at 3 weeks at the earliest and will wait up to 6 moths for ongoing treatment.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Steroid injections after rhinoplasty can cause complications

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Ask your surgeon. He/she knows what was done and the expected amount of swelling. Steroid injections are not without complications. ASK YOU PLASTIC SURGEON, We in cyberspace can not be very accurate, because we cannot examine you

Samir Shureih, MD
Baltimore Plastic Surgeon

Steroids after rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I like to wait at least 6 weeks prior to starting injections, but there is no cut-off date as to when they can be given. After a second rhinoplasty, your nose will be swollen much longer, so just be patient for now prior to judging your results. Good luck, /nsn.

Steroid injections for post operative rhinoplasty.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

 I only use these if the swelling is not going down normally and there is a stiffness to the area above the tip after 3 months. You can wait longer without a problem.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Post rhinoplasty time frame for steroid injections

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Steroid injections to manage swelling are most beneficial during the first three months after rhinoplasty surgery. Some patients require injections beyond this time period, depending on their skin type.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Your swollen tip 5 weeks after Revision Rhinoplasty will continue to improve with time.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The wide appearance of your nasal tip is likely due to swelling after your surgery. It is too soon to have any "scar tissue" formation in your tip. You could discuss a steroid (triamcinolone) injection with your surgeon. You could also discuss a short course of oral steroids to help bring down some of your swelling.

I hope this is helpful for you

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

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.