Rhinoplasty consultation with Dr. Eskandarzadeh | Steroid Injection

Introduction of Dr. Eskandarzadeh

I am Dr. Hesam Eskandarzadeh, I am an ENT specialist, head and neck surgeon, a member of the university faculty and my field of activity is facial cosmetic surgery such as blepharoplasty, sinus, eyelid and especially in the field of rhinoplasty.

Who is good candidate for steroid injection after rhinoplasty?

It is not necessary for all noses, but it is better to first explain what corticosteroids are supposed to be inserted into the nose.

Corticosteroids are drugs that have a significant effect on reducing and relieving inflammation and are used in the following three ways:

• Inhalation method: It is prescribed for shortness of breath after nasal surgery.
• Oral method: This method is used for 10 to 20 days to reduce inflammation.
• Injection method: It is done intramuscularly and locally inside the nose.
• Intramuscular injection method: In order to reduce inflammation, a few days after surgery, some surgeons prescribe drugs such as dexamethasone, betamethasone, etc., which are from the corticosteroid family.
• Topical injection method: This method is done to reduce inflammation and prevent and eliminate scars (excess flesh) or when part of the nose after surgery is more swollen than other parts. In this method, intranasal injection is performed and is not necessary for everyone and is mostly used for fleshy noses. However, it is rarely used for bony noses.

How Long After Rhinoplasty One Can Have Steroid Injection? And how many steroid shots can you get after rhinoplasty?

This injection can be done at least 1 month after the nose operation. However, some doctors believe that 3 to 4 months must have passed since rhinoplasty before corticosteroids can be injected. Corticosteroid injections after nasal surgery can be done up to 4 times.

How long after rhinoplasty can you take steroid injections?

There is no maximum time, but basically the effect of corticosteroids is much less after 6 months. Of course, it may have an effect after 6 months, but the maximum effect is usually before 6 months.

Should it be taped after steroid injection as well as after rhinoplasty?

It is recommended to use two layers of tape between the first 1 to 2 weeks, so that the injection has a good effect on the tissue and has a greater effect. Of course, some doctors consider a longer time depending on the amount of injection and the desired result.

Are steroid injections painful?

No, since corticosteroids are injected with an insulin needle, the pain is quite tolerable and takes a very short time, between 2 and 3 seconds.

What happens if you do not inject steroids, contrary to your doctor?

Swelling in that area goes away later and may not even go away. Of course, dear patients, make sure that the issue of injecting or not injecting corticosteroids is completely in accordance with the doctor's opinion, and on the other hand, the patient should not decide for the doctor whether to inject corticosteroids or not, because some problems inside the nose are not eliminated by injecting corticosteroids. In general, the use of corticosteroids is completely up to the doctor and try to trust your doctor.

What side effects do steroid injections have?

In general, there is a negative angle of view to corticosteroids, which is correct, but this is the case if the injection is used continuously and intramuscularly. But because the corticosteroid injected into the patient's nose is very diluted and the dose is very low, it does not harm the patient.

But the next important point is that this injection must be done by a doctor. Because the location and depth of the injection is very important, any mistake in this regard may cause problems such as skin discoloration, dents or other problems.

Of course, it should be noted that the conclusions about the indent after corticosteroid injection should be waited for 1 to 2 weeks, because these indents are usually a local reaction that is temporary and resolves over time.

What should be done if the indentation becomes permanent after steroid injection?

The next step should be taken depending on the patient's condition and the doctor's opinion, and it is not possible to define a general prescription for everyone.

Who is allowed to inject corticosteroids into patients' noses? Should this only be done by a surgeon or can a secretary or assistant do the same?

Well, defiantly other people, such as a nurse or doctor assistant, are not allowed to inject, and due to the importance of the concentration and also the injection site, this injection should be performed only by a surgeon.

Is there special Do and don'ts after cortisone injection?

No, except for taping the nose that needs to be applied, there is no special care and all care must be done at the usual level.

Which part of the nose is corticosteroids usually injected into?

Most injections are given at the site of the nasal Supratip (above and around the tip of the nose). Because there is more fleshy tissue in this area and the skin is thicker. Due to the fact that the skin in the upper parts of the nose becomes thinner and the bone tissue gradually replaces the fleshy tissue, the need for corticosteroid injection is less.

Does the country or brand of corticosteroids matter?

Each medicine is available in different brands, in Iran we used the TriamHexal brand for a while, which also had a good effect. But if this brand does not exist, we use other options of different brands that may have slightly different effects.

Is it normal to have swelling after steroid injection?

At the same time as the corticosteroid is injected, because a volume of fluid is injected into the nose, it usually swells even more, and this effect may usually be present for one to two days, but usually after a short time the fluid is absorbed into the tissue and swelling disappears.

Can diabetics get steroid injections?

There is no prohibition on topical nasal injection due to its dilution and low dose. However, it is forbidden to prescribe corticosteroids intramuscularly or orally to the following people:

• Diabetic patients
• People who have uncontrolled sugar
• People who have an immune system defect
• and other special patients

What do steroid shots do to your immune system?

Specifically, in the nasal injection method, no (low-dose diluted corticosteroids)

, But the discussion of intramuscular or oral injection has its own conditions and is a completely different discussion.

How much do steroid injections cost after rhinoplasty? Is it free?

It depends on the doctor's condition and rules. For example, I do not charge for this work like changing the tape. But some colleagues charge a separate fee for this, which of course is not a problem because each doctor has its own rules.

Every cortisone shot typically cost between $15 to 30 in Iran.

Can steroid injections make your nose smaller without rhinoplasty?

No, corticosteroid injections are not suitable for those who have not had rhinoplasty because there is no swelling, so there is no need for injection.

Is corticosteroid injection different from enzyme injection?

Unfortunately, many people think that corticosteroids and enzymes are the same, but this is not the case. Please do not inject enzymes in any way. If you search, no ENT surgeon will inject the enzyme into your nose. Because the side effects of the enzyme are very high and like the injection of acid inside the nose, it destroys all the tissues of the nose and has uncontrolled effects.

 Of course, these effects may be positive for a limited number of people, but by no means do not accept this risk because some people get positive results.

Enzyme injections have frightening effects and are a red line for surgeons. Even many surgeons, including myself, do not accept these people for surgery if a client has injected an enzyme before the nose operation because all the nasal tissue is broken.

What are the cons of nose filler?

Filler injection is in the category of non-surgical rhinoplasty, which there are many articles about it now.

It certainly has far fewer risks than the enzyme, and many people do. But in the case of filler injection, the following points should be noted:

• Filler injection in which service center!
• What injection should be done?
• In what treatment program should it be done?
• What is the type of gel? And not every gel should be ingested.
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The fact that some people do this in beauty salons is one of the main problems. Because the hairdresser does not know the anatomy of the body. The hairdresser does not know in which places of the face there are vessels! In general, the filler has its own risks, except in cases where minor changes are needed in the nose dorsum, which must be done by a specialist surgeon familiar with facial anatomy.

Do you have to dissolve filler before nose job? Can you have a nose job with filler?

We usually recommend that wait 5 to 6 months for the filler to be dissolved, and in some cases, if possible, we empty the filler during the operation. But I usually wait until 6 months have passed since the filler injection and then I do surgery.

Do you need a prescription for an intramuscular steroid shot?

It usually causes a defect in the immune system, because it is not used diluted and is not recommended at all without a doctor's prescription.

Is corticosteroid injection useful for relieving asymmetric swelling?

Due to the fact that the number of changes in the nose during surgery may not be the same on both sides of the nose, naturally, nasal inflammation may not be symmetrical, but in these cases, corticosteroid injection can be effective in reducing this unilateral swelling.

Can steroid injections make your nose smaller? Is it a fast process?

Because corticosteroids are injected topically and have a local effect, we should not expect them to have a large effect on shrinking the nose. Rather, it can only be said that it eliminates swellings, but the most important factor for eliminating swells is the passage of time.

An important point to note is that the goal of rhinoplasty is not necessarily to shrink the nose, but to harmonize the components of the face with the nose, and not every change in the nose can be made at the request of the applicant.

Rather, the ultimate goal should be that the nose fits the applicant's face and the harmony of the face components is observed.

So, a small nose is not necessarily the goal of rhinoplasty, and the main goal is to fit the components of the face along with proper breathing.

Can you explain a bit about the Accutane? How long after Accutane can you get a nose job?

Accutane capsules are a brand with the scientific name of isotretinoin 20 mg and are mostly prescribed by dermatologists to use to eliminate pimples.

For fleshy noses, we usually prescribe one month after surgery to reduce swelling for some people (30 capsules for two months). Of course, the use of this capsule has its own terms and conditions, for example, for pregnant women, those who consume alcohol and those who have liver problems are prohibited.

 This medicine has its own side effects such as dry skin, scaling of the lips and dries the body in general, but in general it has a good effect in reducing the swelling of fleshy noses.

Regarding the period of discontinuation of Accutane before rhinoplasty, the use of Accutane before rhinoplasty was banned until a few years ago.

But recently, articles have been published that allow a nose job to be performed three to four months after stopping Accutane. But since rhinoplasty is not an emergency operation and I am a conservative person, I usually wait up to six months after stopping Accutane and then have the operation.

Important Note: The administration and use of this medicine should only be done by a specialist doctor and with periodic liver tests, and in no case should this medicine be used autonomously.

What is inhaled corticosteroid? Who should use inhaled corticosteroids?

We do not use tampons in our rhinoplasty technique, so the mucosa inside the nose is inflamed for a few days after the operation, and we should not expect this breathing to be like someone who has not had rhinoplasty.

 One of the most common problems that patients tell us is that they usually have trouble breathing at nights and usually the nose is blocked, and this blockage usually occurs sinusoidally and is sometimes taken and sometimes the nasal passage is opened.

 This blockage is due to the lower tentacles, which are the size of two beans inside the nose, and in cases of allergies or inflammation, especially in cases where the patient is asleep at night and blood flow to the head and neck, these tentacles become inflamed and cause temporary obstruction of Breath flow through the nose.

One solution to this problem is corticosteroid nasal spray, which is available in pharmacies under the brand names “Fluticasone” or “Mometasone furoate” or other brands. The method of using this spray is two pops on each side of the nose every 12 hours, which is prescribed with a washing serum and an antihistamine pill, and solves the problem.

What are the dangers of Sudafed? And How addictive is Sudafed?

Two medicines, oxymetazoline and phenylephrine or the same as Sudafed, play the role of drugs. This means that as long as you use it, it is good and when it is cut off, the conditions are worse than before.

It should be noted that when doctors prescribe these medicines, there is a limited period (4 to 7 days) that must be observed. It is true that after using these medicines, breathing becomes very easy, but the problem is that your body gets used to it, and not only should the consumption increase, but the possibility of stopping taking it becomes harder and harder.

Free rhinoplasty consultation with Dr. Eskandarzadeh by Direct link and number +989015057889 on WhatsApp.

This rhinoplasty consultation conducted by "tajrobeamal.com group" with plastic surgeon "Dr. Hesam Eskandarzadeh" about Rhinoplasty in Iran , steroid injection , using Accutane , filler treatment and some tips about cosmetic surgery in IRAN.

source : instagram.com/tajrobe.amal.bini