I have a big crooked nose, and I am getting it fixed. I was wondering how bad the scarring will be and how long I have to wait before the scarring looks less noticeable? I have brown skin if that matters.
Concern About Scarring After Rhinoplasty
Doctor Answers (5)
Skin scarring is not a problem with rhinoplasties. Most of the incisions are made within the nose.There are two exceptions: 1) Sometimes incisions are made at the junction of the upper lip and nose to narrow the base of the nose. 2) With the open rhinoplasty technique an incision is made in the columella between the nostrils. I have used the open technique for thirty-two years in revision and augmentation rhinoplasty surgery. I have not had a problem with scars in any of these procedures.
Scarring should not be a problem.
Your surgery can be performed using either an open or a closed approach.
The open approach means that an incision is made across the columella. This is the part of the nose which runs from the middle of the upper lip to the tip of the nose. A good rhinoplasty surgeon knows how to make this incision so that it heals well and is inconspicuous.
The closed approach means that the incisions are made inside the nose. It is more difficult to do a rhinoplasty this way, but it can be done.
If you need a lot of work on your nose, the open approach might be better.
Research your doctor and make sure to look at before and afters of their work. If they are a good surgeon, and you heal normally without complication, then you should not have any problem with abnormal scarring.
It is possible, just rare
Rhinoplasty can be done either with an incision on the outside of the nose (at the bottom, between the nostrils) or withouth any incisions on the outside. Realistically, there is a chance that the scar can be visible. When it is visible, its usually because the edges dont quite match up well, rather than a problem with the pigmentation. This is really, really uncommon though. Its so rare that we routinely advise our patients that the concern for scarring for a routine rhinoplasty should not be a major factor in your decision. The exception is for the times when we make additional incisions to make the nostrils smaller. These are sometimes placed in areas that can also be potentially visible. Visible scars in this case are also very uncommon, but in my opinion are more likely than the routine incisions for exposure in rhinoplasty. Therefore its appropriate to discuss these incisions with your surgeon in detail.
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Scarring should not be an issue.
In more than 30 years of doing open rhinoplasty I've never had a bad scar. This was what surgeons said at that time because they didn't do it. I do rhinoplasty both ways and your surgeon will pick the way he thinks will give you the best result. Choose a good, experienced rhinoplasty surgeon and you should not have any scarring issues.
Rhinoplasty scaring depends on your surgeon's approach
These are great questions for your surgeon and I recommend that all people considering rhinoplasty discuss the topic of scarring at their consult.
Visible scaring after rhinoplasty depends on the aproach used by your surgeon. The two main aproaches are "open" and 'Closed".
A closed aproach is most appropriate for noses requiring subtle contour changes. The inscisions are hidden on the inner surfaces of the nostrils where they can not be seen.
A severely twisted nose or a nose that has been operated on previously is often better suited to an Open approach. In this case, a small well designed incission is placed in the collumella ( the skin that seperates one nostril from the other). While this can vastly improve the surgeons ability to correct severe nasal problems it dose produce a very small scar. Most patients find it hard to detect once healing has occurred but with darker skin it may be more noticeable.
All the best to you.