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Matthew M. Hanasono, MD; Russell W. H. Kridel, MD; Norman J. Pastorek, MD; Mark J. Glasgold, MD; R. James Koch, MD

Arch Facial Plast Surg. 2002;4:26-30.

Objective  To describe the technique for correction of the soft tissue pollybeak deformity using intralesional injection of triamcinolone acetonide.

Methods  We discuss our philosophy, regimen, and technique for treatment of the soft tissue pollybeak using triamcinolone injection. We include results from a series of 173 patients who underwent rhinoplasty performed by one of us (N.J.P.).

Results  Triamcinolone was injected at 1 week after surgery in 127 patients (73%). A second injection was performed in 92 (72%) of the 127 patients at 4 weeks after surgery. One hundred eight (85%) of the 127 patients had an acceptable result, as judged by the surgeon, with good supratip definition. Nineteen (15%) of the 127 patients had a less than optimal result, with residual supratip fullness, as judged by the surgeon. There were no complications caused by triamcinolone injection.

Conclusions  Because revision surgery is difficult and may be associated with complications, intralesional triamcinolone injection is the first-line treatment for the soft tissue pollybeak deformities caused by subdermal scarring. Should intralesional steroid injection fail to satisfactorily treat the deformity, revision rhinoplasty can subsequently be performed.

From the Division of Otolaryngology–Head and Neck Surgery, Stanford University Medical Center, Stanford, Calif (Drs Hanasono and Koch); the Department of Otolaryngology–Head and Neck Surgery, Division of Facial Plastic Surgery, University of Texas Health Science Center, Houston (Dr Kridel); the Department of Otolaryngology–Head and Neck Surgery, Cornell University Medical Center, New York, NY (Dr Pastorek); and The Glasgold Group, Highland Park, NJ (Dr Glasgold).

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