After consulting the doctor I'm planning to have the operation with, he told me in a revision rhinoplasty he doesn't remove any scar tissue, he just carefully deals with it. Should scar tissue be removed during surgery?
Removing Scar Tissue in Revision Rhinoplasty?
Doctor Answers (3)
Addressing scar tissue in revision rhinoplasty
It is very difficult to remove scar tissue form a revision rhinoplasty. There are layers of scar tissue present and they are addressed at the time of the procedure. Removing 1 layer of scar tissue just adds another on top of it so it really is fruitless to remove just scar tissue. Scar tissue can sometimes be softened or melted with cortisone shots in the postoperative period.
Revision rhinoplasty and scar tissue
There are no golden-set rules to follow in revision rhinoplasty, as each surgery must be tailored to the individual. Sometimes, the scar tissue is addressed, and other times not. We do what is right for the patient without something being set in stone.
If scar tissue is removed, more scar tissue can form
The term, "scar tissue" can mean different things when one is talking about rhinoplasty. Commonly, it is used to describe the thickening of the soft tissue envelope after rhinoplasty. In some cases, this can cover over the changes made to the cartilage and bone, preventing the surgical refinement from being visible to the outside world. In my experience, when this happens, it is because the initial surgery was not planned or executed properly. If this type of scar tissue develops, it can be difficult to remove it, as it can be quite adherent to the soft tissue envelope. Attempting to remove it could lead to contour irregularities of the soft tissue (hard to fix) or regrowth of scar tissue. A lot depends on the skin type of the patient. In thin skin patients, some scar tissue is helpful to camouflage any irregularities under the skin surface. In thick skin, scar tissue can create problems by shrouding the results. An experienced surgeon will know best on how to deal with scar tissue in a revision. See the link for a video I created explaining some of the differences between thin and thick skin in rhinoplasty.