I had primary open rhinoplasty two years ago and I'm generally very happy with the results. The only problem is a visible columella scar near one nostril. This area didn't seem to be closed properly after surgery, it wasn't gaping, but it wasn't a neat close like the other side which has healed beautifully. Any opinions on the best way to make this less noticeable? Dermabrasion? If scar revision is an option, is there a risk of it changing the nostril shape?
Rhinoplasty Columella Scar? (photo)
Doctor Answers 12
Columella Scar #nosejob
Most likely you will need a scar revision this far out. That can be done in the office most of the time. Dermabrasion may be an option but I would have to see the scar to determine if revision or dermabrasion would be best.
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I agree with your evaluation of the scar. Your surgeon can revise the scar with minimal excision of the depressed tissue under local anesthesia. You should have a very nice result.
The columellar scar can easily be improved with scar revision
Prevention of course is the best scenario (a carefully closed, meticulous suture line generally results in a near invisible scar). But when a problem like this ensues, an excision of the problem part of the scar and careful re-closure works well. As long as a minimal amount of tissue is removed, no distortion of the nostril landmarks should occur. This assumes that your skin is supple and soft (and not extremely stiff as in the case of multiple revision noses).
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You demonstrate the #1 issue with the open rhinoplasty technique- columella scarring! In my opinion only scar revision will help.
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Centralcity, it is my opinion that formal scar revision would be a better choice for the issue seen in your photo provided. This should not result in much nostril reshaping if the scar is carefully revised by a facial plastic surgery expert.
Scar for rhinoplasty
A scar revision is more appropriate if you are unhappy with the scar
Dermabrasion works better in the early phases of healing (first 6-8 weeks)
Usually the columella scar heals exceedingly well in the majority of patients, but if at two years it is irregular like yours, perhaps a scar revision is in order. Good luck.
Columellar scar after open rhinoplasty.
You should have your surgeon revise his scar. It should look much better than that.
Columella scar after rhinoplasty
I think you are best served with a scar revision. If the scar revision is properly planned and executed then the risk of changing nostril shape should be very low. I am not optimistic about achieving significant improvement with fillers or dermabrsion.
Stewart Wang, MD FACS, Wang Plastic Surgery
Because of the overall dent at the scar point it will need a scar revision. I don't think filler alone will correct it perfectly although well worth a try first - if it works, wonderful.
A scar revision with gentle eversion of the freshened edges should give you a perfect scar and is an office procedure under local anaesthesia only.
Well worth a visit to and a discussion with your surgeon.
All the very best.
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