Columella Scar Following Rhinoplasty

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars.

Best,
Dr. Karamanoukian
Realself100 Surgeon

A beautiful columella scar requires meticulous attention to detail when closing the wound. If the skin isnt perfectly aligned, and if the dead space within the wound isnt filled (which is why I use a two layer closure) noptching and step offs occur. I agree with having a revision performed by the same surgeon to correct it.

Dear Kelly from white plains,
I reviewed basal view of your nose pictures, I agree that there are step-offs on both sides. However the incision site has healed well. If the step-offs are your main concerns after your initial rhinoplasty, I would recommend seeing your own surgeon to correct them. This could be performed under local anesthesia with no charges to you.

I read your concerns and reviewed your photo. If you have other concerns about the appearance of your nose that would require surgery, then you should not undergo an in-office scar revision. Since you're having concerns about your rhinoplasty surgeon, please see several reputable rhinoplasty specialists to see what would be best for you. Feel free to email your photos along with a description, and I'll be happy to share my thoughts with you.

If the "step off" was your only concern, I would personally consider an injection of Silikon-1000 into the notch on each side rather than a scar revision.

I hope this is helpful for you.

Hi Kelly,

You should be sure that your rhinoplasty surgeon understands your concerns and feels that he/she can accomplish the correction.  If you are confident in your surgeon then it isokay to have the revision by the same surgeon.  If not choose another surgeon carefully whom you trust.  It may be a good idea to get a few second opinion consultation either way.  Good luck and be well, hope that you get the nose that you desire.

Dr. P