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I have had two rhinoplasties over the last six years. The first left me with...

Q:

I have had two rhinoplasties over the last six years. The first left me with extensive scar tissue in the tip of my nose. The second removed this, but it came back after a while. I have been having cortisone injections which make my nose look tighter and smaller. However, after about 6 weeks, it returns back to normal. The skin left at the end on my nose is rather bulbous and thick – the cortisone shrinks this only temporarily. I have heard about thermage and was wondering if this would be feasible to use on the tip of my nose. Would it make a favorable difference or is it possible that it would increase the scar tissue built up inside the tip? What in your opinion would be the solution to my problem of a bulbous tip?

A:

It is somewhat difficult to give exact advice without looking at the nose. Regarding the characteristics of soft tissue, cartilage support, etc……..if the last surgery was done less than 12 months ago, it is quite possible that time will shrink soft tissue over the tip further. If the problem you have is supra tip deformity, surgical correction is possible with removing a small portion of the septum above the nasal tip. If there is too much skin over the tip, and not enough cartilage support, that problem may have to be addressed. Limited cortisone injections are fine, however, too many or excessive cortisone injections may cause additional problems over the nose.

I do not think thermage would be that helpful to you.

A:

Bulbous Tip After Multiple Rhinoplasties – The most important thing is to stop using steroid injections in your nose to allow for the nose and scar to mature.  I would not consider a tertiary rhinoplasty for at least two years after your last operative procedure. I highly advise against using repeat steroid injections in this area or Thermage as it is not effective.

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