Q: Dr. Eppley, I am suffering from an excessive buildup of scar tissue underneath the skin after my rhinoplasty. Multiple Kenolog shots did not help. my nose looks about 30% bigger and more bulbous then it was a few months right after the surgery. (my rhinoplasty was three years ago) I am convinced that 5-fu is the right approach for me now. I know that you are one of the best and most experienced surgeons known for using this post surgery corrective method. Can you please help me?
A: I would not think that 5-FU injections would be helpful for established scar tissue years after the original rhinoplasty surgery. The biology of 5-FU effects is to inhibit the creation or development of scar tissue, not causing it to break down. Steroids, specifically Kenalog, actually work through a dual effect of inhibition and breakdown of scar tissue. In short, while 5-FU injections can certainly be done, I would not be optimistic that it would achieve the desired effect of nasal size reduction that you desire. It would be better, in my opinion, to have a revisional rhinoplasty for scar removal and then lay in on dissolveable collagen sponges (carrier) a mixture of steroids and 5-FU. This could then be followed by an early and aggressive use of 5-FU injection therapy.
Dr. Barry Eppley