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Plastic Surgery/Nasal Scar Tissue

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Question
Dear Dr. Tobin,

I had two rhinoplasties in the past (once in 2009 and once in 2011). The first surgery was septorhinoplasty to correct deviated septum and nasal hump. The second was for "fine tuning," as there was still a bit of a hump remaining. Furthermore, there appeared asymmetric swelling/scar tissue development on one side of my nose and nasal tip. The second surgery attempted to correct this, and after the removal of the cast, the nose looked perfect. However, beginning two days after cast removal up to today, the swelling reappeared and never healed, so there appears asymmetric bulging on one side of my nasal tip.

I wanted steroid injections for this during the process, but the doctor did not want to give in fear of a "depression" forming. However, I would much rather prefer a depression than this bulging.

Is it possible, after all this time, that I can receive steroid injections from a surgeon to kill/dissolve this scar tissue? If it would cause a depression, I would much rather prefer that.

Answer
Yes, Bilal

Steroid injections can be very helpful to soften of "dissolve" scar tissue following a rhinoplasty.  If done carefully and in stages, the risk of depression is quite low.

On the other hand, from your description,  ( However, beginning two days after cast removal up to today, the swelling reappeared ) , that does not sound like scar tissue.  It is possible that some persistent anatomical problem persists but was not obvious right after splint removal due to swollen.

A thorough re-exam would be needed to determine the exact cause of the problem.

Howard Tobin MD FACS

Plastic Surgery

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Howard Tobin MD FACS

Expertise

I can answer questions related to Cosmetic Surgery. I cannot answer questions related to reconstruction, burn treatment, cleft palate surgery or traumatic surgery. My practice is, and has been for 36 years, limited to Cosmetic Surgery. For further information, go to www.newlook.org

Experience

As mentioned above, I have exclusively practiced cosmetic surgery for over 36 years. My practice encompases all aspects of cosmetic surgery

Organizations
American Academy of Cosmetic Surgery (past president) American Society of Liposuction Surgery (past president) Cosmetic Surgical Society of Texas (past president) Fellow American College of Surgeons Texas Medical Association see cv on website www.newlook.org for further details

Publications
Seventy three published articles. see cv on website www.newlook.org for further details

Education/Credentials
Graduate of Princeton University and Baylor College of Medicine Internship - University of Virginia Residency - Baylor Medical College Affiliated Residencies Fellowship - University of Cincinnati see cv on website www.newlook.org for further details

Awards and Honors
American Medical Association - Physician's Recognition Award; 1969- present American Academy of Otolaryngology - Head and Neck Surgery Honor Award, October, 1983 American Board of Cosmetic Surgery - Certificate of Appreciation - 1987 American Academy of Cosmetic Surgery - Best presentation at 1987 annual meeting: "Revision Mammaplasty with Replicon Prosthesis" Accreditation Association for Ambulatory Healthcare Certificate of Appreciation 1989-90 American Academy of Facial Plastic & Reconstructive Surgery Honor Award for distinguished service, 1989 American Academy of Facial Plastic & Reconstructive Surgery Appreciation Award for authorship of monograph on outpatient surgery , 1993 Certificate of Excellence in Continuing Medical Education in Cosmetic Surgery, 1993 - American Academy of Cosmetic Surgery. International Academy of Aesthetic Surgery & Aesthetic Medicine - Honor Award, 1994 American Academy of Cosmetic Surgery - Recognition plaque following term of Presidency - 1995 Accreditation Association for Ambulatory Healthcare Special Citation of Appreciation for Service; November 1996 International Academy of Aesthetic Surgery & Aesthetic Medicine - Appointed honorary North American President, 1995 1997 American Academy of Cosmetic Surgery: Award for excellence in cosmetic surgery; Jan 2003 Cosmetic Surgical Society of Texas Appreciation Award for Leadership; 2004 Honorary Member Mexican Academy of Cosmetic Surgery 2007

Past/Present Clients
A past sponsor of the Miss Texas USA pageant, he has also served as a judge for this and other pageants. His patients include many pageant contestants and winners up to the Miss Universe title

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