I had an open rhinoplasty 11 days ago. This morning I've replaced tapes and I'm shocked by the scar. It is irregular, and on the right side seem that a piece of skin is missing. I feel really bad about this situation...it will improve or there's no way? I will see my doctor only on Friday. Thanks in advance.
Columella Scar - I'm Worried About It? (photo)
Doctor Answers 14
Columella Scar - I'm Worried About It?
I have read all the expert responses and I will interpret them a bit differently. I believe you need a revision of the columella incision. Either the closure was NOT "lined" up properly, or a dehiscence has occurred, or as Dr Prendiville stated the caudal edge is out of line causing the appearance of an uneven closure, or a combination of these effects. Either way see you surgeon ASAP to understand this issue and determine a plan for correction. Whether it will be observation of the stages of healing to see if there is any improvement or an immediate surgery to correct is up to YOU and your chosen surgeon (I hope he/she) was a boarded surgeon.
You definitely have a poorly aligned skin edge when the closure was performed thus making the scar look obvious but this is compounded by the fact that the caudal end(lower end) of the septum is deflected to the right and into the right nostril. The scar should be revised but not for at least 3 months to allow healing to occur from the original surgery and the possibility that it may improve. In 3 months both the scar and the septum can be corrected to correct the present deformity.
Unusual nasal scar post-rhinoplasty - Dr. Marc DuPere answers...
Thank you for your question. I must say it does look more irregular than most normal average columellar incisions. Please see your plastic surgeon to rule out opening of the wound - dehiscence - or infection. Rhinoplasty scars can be light red and swollen at 10 days post-op but should be fairly well aligned. Good look! Dr. Marc DuPere, Toronto Plastic Surgeon, board-certified 416.929.9800
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Columllar scar after rhinoplasty
Even though it is early in the healing process for your columellar incision, I must say that it looks more irregular and asymmetric than I am used to seeing. I would have your surgeon examine this immediately to make sure there is not an infection/abscess/hematoma or otherwise.
Columella Scar after 11 Days
At 11 days after surgery, it is not wise to judge your scar due to swelling. Most columellar scars are irregular and commonly have a "stair-step" appearance. It will improve in a few weeks.
The appearance of this columella is worthy of concern.
Generally it's unwise to make judgments about healing nose for weeks after an operation. In this case the asymmetry is bothersome. It looks as though some of the cartilages in the columella may be eccentric. I would talk your plastic surgeon to get a hands-on opinion and some reassurance.
On the positive side, columellar skin usually heals almost imperceptibly. So much so that I have never had to revise one of my scars. However, the base view shows irregular swelling, possibly related to deflection of the caudal septum. I would definitely raise these concerns with your Surgeon, although he/she is likely to advocate (correctly) a watch and wait policy until the swelling subsides.
The appearance of your columellar closure is concerning. Go in to see your plastic surgeon for an exam to determine what is the next step. Kenneth Hughes, MD Los Angeles, CA
I would contact your surgeon and have your incision evaluated in person at this time. The incision does not appear like it is healing normally at this point.
Columellar scar problems
This is not what the usual columellar scar looks like even early on. I'd suggets that you contact your doctor today and either be seen or at least send in these photos for them to evaluate. They may want this to heal and then do a revision. It all depends on what was needed and what was done. But if you chose an excellent doctor they'll get you through this.