Question from Madison, CT: I had a Kenalog 40 injection into a raised hypertrophic incision scar which got rid of the all the scar tissue in a week. I have read the Kenalog stays in your tissues for a month. I would like to get some restylane in the area, but do not want the water absorbing properties of restylane to hold the steroid in place for longer than a month. Is it safe to get restylane soon – or is there a way, such as a saline injection, to help flush out the remaining Kenalog beforehand?
Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers:
Kenalog is a suspension of a synthetic steroid used to reduce inflammation. When used under the skin or intralesionally, as you have, it stays localized to the injection area for a prolonged period of time; 40 days per the prescribing information (see reference below). Kenalog is NOT ordinarily used as a water or salt retaining steroid as other glucocorticoids are prescribed.
You should have no trouble receiving Restylane or any other HA (hyaluronic acid injectible) outside the area of a Kenalog skin injection.
I wish to wait 6 to 12 weeks (42 to 84 days) following injection of kenalog in a hypertrophic skin lesion to allow it to fully work prior to assessing whether a patient requires more kenalog or as you suggest a filler. This will allow you and your injector to determine the extent of atrophy caused by the steroid and the amount, type and placement of filler you will need.
Always use the most experienced, board certified plastic surgeon or injector for your skin injection needs.
I hope this was helpful! All the best.
Dr. Dean Kane