Prominent Indented Columella Scar. What Are my Treatment Options? (photo)

Thank you for the great question and the pictures.  As some others have said, the issue with revising this type of scar is that you can't get rid of any tissue without affecting the shape or projection of the tip of the nose. While it is true that the incision can be made again, without cutting away the depressed scar, the improvement would likely be minimal at best. It would be possible to remove some of the anterior-most part of the septum to provide laxity, which would then allow the scar to be trimmed, but would also change the tip shape somewhat. A final option that I have used in my revision rhinoplasty practice is laser resurfacing. Using low settings (because of the sensitive nature of the skin here), some improvement in texture and surface smoothness can be achieved.
 

 One camouflage solution would be to trim back the membranous and  cartilaginous septum to reduce the columellar show, and thereby making this columella not quite so prominent and helping hide this scar

     The scar can be revised under local anesthesia with closer approximation of the respective tissues.  Kenneth Hughes, MD Los Angeles, CA