Topical steroids to reduce skin thickness after rhinoplasty - are there any adverse effects?

Question

I had a rhinoplasty 13 months ago and still have a lot of swelling in the nose tip. It went down for 1-2 weeks after steroid shots but returned again, but apparently topical steroids (ex. triamcinolone acetonide) can thin the skin and reduce swelling. Therefore, I was wondering if this makes sense and would have any adverse effects of long term use that I haven't been able to find.

Semih Yildiz, MD, FEBOPRAS · Answer

Topical triamcinolone does not reliably treat deep postoperative tip swelling or scar tissue, and intentionally thinning the skin is not a safe rhinoplasty strategy. Prolonged use on facial skin can cause permanent atrophy, visible small vessels, pigment change, acne-like eruptions, delayed healing and increased infection risk. It may also mask dermatitis or another skin condition.

At 13 months, the remaining fullness could reflect thick skin, scar tissue, residual edema or the underlying cartilage shape. The brief response to injections does not by itself establish which one is responsible. Repeated injected steroid also carries risks of thinning, dents and discoloration, so it should only be used when an in-person examination identifies a localized scar pad and the dose and plane are carefully controlled.

Return to your operating surgeon or an experienced rhinoplasty surgeon before using any topical or injected steroid. If you are still 17, involve a parent or guardian in that evaluation and treatment decision.

Eric M. Joseph, MD · Answer

All swelling eventually dissipates. And sometimes patience is a virtue. Topical steroids can lead to skin thinning, in a negative way, along with visible capillaries that may be unsightly. Please consider discussing how to move forward with your surgeon. Thank you.

Anil R. Shah, MD · Answer

Hello, my name is Ranen and I am an aesthetic nurse at Aesthetic Skin in Chicago.  It sounds like you're going through a frustrating experience with lingering swelling in the tip of your nose after rhinoplasty, and you're exploring potential ways to help reduce it. Let's break this down and look at whether topical steroids (like triamcinolone acetonide) could help in your situation, as well as any potential long-term effects.  After a rhinoplasty, it's not uncommon for the swelling to persist in the nose tip for months (or even up to a year). The healing process varies from person to person, but the nasal tip tends to be more prone to prolonged swelling due to factors like: Thicker skin: The skin at the tip of the nose is often thicker, which can make it take longer to heal and for swelling to resolve. Cartilage and soft tissue healing: The internal structures of the nose may take more time to fully heal and settle, which can contribute to persistent swelling. Blood supply: The nose tip has a lot of vascular supply, which means that inflammation and swelling can linger longer as blood flow continues to promote healing.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. The final results take at least 1.5 years for the swelling to fully resolve. This can require lots of patience and waiting. Steroid injections performed by your surgeon can be extremely helpful. I usually start steroid injections around 1 to 2 months after surgery and continue as needed. With that being said, the final outcome will really depend on the surgical techniques that your surgeon used during your surgery. I recommend that you maintain close follow up with your surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Zoran Potparic, MD · Answer

Yes, we frequently use injection of corticosteroid into nasal tip, usually supratip area where swelling is most intense and leaves permanent deformity if not treated. However, this should be done only by your surgeon since extended use of corticosteroids may have negative effect like skin thinning, dimpling, discoloration. Good luck.

Topical steroids to reduce skin thickness after rhinoplasty - are there any adverse effects?

Answers (5)

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