After a rhinoplasty, some patients may have a predisposition to have a larger amount of swelling or develop scar tissue in the nose. This can occur with both closed (endonasal) or open (external) rhinoplasty procedures. The area where the majority of the swelling takes place is in the supratip, the area just above the tip. If this area remains swollen or scar tissue forms here, patients can develop extra fullness in the supratip, termed a pollybeak.
Kenalog, triamcinolone acetonide, is a type of steroid. It comes in various strengths ranging from Kenalog 10 mg/ml to 40mg/ml. Kenalog is the most commonly used type of steroid for post rhinoplasty injections. Injections are used primarily in the supratip of the nose to help decrease the amount of swelling and reduce the amount of scar tissue formed here. It is much less common to use kenalog in other portions of the nose.
There are many theories on why some patients are disposed to form scar. Some theories show that excessive scar formation is a result of excessive formation of collagen by fibroblasts, a type of cell found in the body. One growth factor thought to stimulate fibroblasts in making excessive collagen isTGF-β. Kenalog inhibits collagen production and fibroblast formation by decreasing the amount ofTGF-β.
The main risks of using Kenalog is a depression in the skin. The other risks include change in coloration (called hypopigmentation), abnormal blood vessel formation, and thinning of the skin.
Kenalog injections should be done judiciously and with experience in this arena. As with any procedure, a certain amount of risk and benefit is involved and can be weighed. Kenalog injections can be done at any time after rhinoplasty and create some effect. Most patients see some effect within a 2 weeks span after an injection.
Are Kenalog injections painful?
There is a variable response with each patient. Most patients report there is minimal discomfort.
Should you tape immediately after a Kenalog injection?
Typically it is recommended to tape the nose in the supratip for 1-2 weeks after an injection.
Can swelling recur after a Kenalog injection?
Yes, swelling can recur. Typically, a stronger dose of kenalog or additional doses of kenalog may be necessary.
Do I have to receive a kenalog injection after rhinoplasty?
Every patient has a variable response and it depends on swelling and the surgeon’s recommedation
Will Dr. Shah provide a kenalog injection for me if I had a rhinoplasty performed elsewhere?
Dr. Shah recommends patients see their treating physician unless there is some outstanding circumstance.