I am 3 weeks post op and I am wondering if I should be doing anything to help with the healing of the columella incision(stair-step incision). Should I put mederma, or bacitracin on it daily to help so it doesn't scar? Or, should I just let nature takes it course and leave it alone? Thank you!
How Can I Help Healing of Columella Incision?
Doctor Answers (8)
Columellar incisions during open rhinoplasty - improving scarring with rhinoplasty
Bacitracin ointment should help with healing of a columellar healing in the first few days after surgery. I have noticed that the columellar incisions that I have made during rhinoplasty heal very well with minimal treatment after surgery. I remove the sutures from an open rhinoplasty within 5 to 7 days of the surgery. In some cases, I use clear suture to disguise the incision immediately after rhinoplasty surgery.
HybriSil, sunscreen and vitamine E
I usually recommend Hybrisil for about 6 weeks at this point. Make sure that you have sun screen on at all times. After the six week period, I usually recommend vit E ointment
Columella incision - healing
Immediately after surgery, I really stress to my patients frequent application of an antibiotic ointment along the columella incision site. Once the sutures are removed and the incision is well healed over, I typically recommend discontinuing application of the ointment. Redness to the incision site can be expected and typically subsides over time. After this, I strong recommend application of sun sceen to the incision site and for smokers to try and quit or at least minimize their smoking.
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The healing of stair step incision
Usualy the incision heal well and the scar is not visible. This may take two - three months to achieve. Using Medarma, scarguard or other scar porducts may help. You are only three weeks out and your concern is valid. But, give it more time and you will see a significant improvement. If this is your only concern after rhinoplasty then I think you had a good surgery.
Columellar incision in open rhinoplasty
The columellar incision typically heals without a visible scar if it is repaired with meticulous attention to detail. At three weeks, sun protection is important. Scar gels will do no harm, but as pointed out by others, have not been proven to result in better healing.
Columellar incisions typically heal without a perceptible scar in most Surgeons hands. There is no scar cream or scar treatment that is clinically proven to speed up the wound healing process that we, as humans, are genetically designed to have.
How to optimize healing of columellar scar
I tell my patients to perform twice dialy incision line care with diluted peroxide followed by plain vaseline for the first two weeks after surgery. After that it is important to place sun block of SPF 30 or higher on the scar when going outside for 6-12 months to prevent darkening of the scar. Other than that there's not much else to do, though mederma won't hurt to use. I find that with chronic use bacitracin (or other antibiotic ointments) often cause a contact dermatitis (redness, itching) so I tell my patients to avoid using that type of ointment.
Of course, I would follow the instructions of your surgeon as that's who knows your particular situation best.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.