Should I Have External Scars from a Nose Job?

All types of rhinoplasties share the same incisions inside the nose. However, there are three areas on the outside that a surgeon may make an incision: Collumela - This is the bridge between the nostrils. This is the most common incision in open rhinoplasty. Majority of surgeons use this incision in their technique. The incision could be step or V shaped. The best thing about this incision is that with time it is undetectable. The fact is that most famous plastic surgeons perform... more

Dear Jay, NYNY As a plastic surgeon I perform the rhinoplasty procedure either with internal (inside the nose only) incisions, or sometimes combined with skin, or external incisions. This distinction is otherwise known as either the "closed" or "open" technique. Much of this is determined on the difficulty of the procedure, and/or the training of the surgeon. When perorming an "open" approach the additional external incision is placed across the the mid... more

There are certain circumstances where incisions on the outside of the nose are necessary to provide the best results. The incision across the columella (the structure between the nostrils) is very common and allows the surgeon to perform an "open" rhinoplasty. In this operation, the structures of the nose are seen directly rather than through incisions only in the nostrils. Many believe this provides greater accuracy and predictability of the result. The scar is almost never... more

It depends on the type of rhinoplasty that you had and the actual parts of the operation which were performed. The two main types of rhinoplasty are open and closed. In a closed rhinoplasty, all incisions are made on the inside of the nose. Unfortunately this is not the best approach for some patients. In an open rhinoplasty, most incisions are on the inside of the nose except for one that goes across the columella, the bridge of skin that goes from the tip of your nose to your upper lip.... more

In general if you have had an open rhinoplasty, incisions are placed on the columella (the divider of your nostrils) and occasionally at the base of your nostrils (if your surgeon has narrowed the base of your nose). I am unsure as to the significance of the circles you describe. It does not sound normal to me, but you will just have to see what happens when your bandages come off. More than likely it is a normal variant and you have nothing to fear.

Incisions on the side of the nose, by what are called the alar rims, are performed in patients that either have too much flare of the nostrils, or for nostrils that are too wide. Usually the stitches are removed within 1 week. I am surprised you did not anticipate this, because if I plan to do an excision along the alar base I always discuss this with my patients beforehand.

The scaring that a patient will have following a rhinoplasty largely depends on the technique used. Many surgeons use an open technique, which generally results in a scar that is zigzag on the columella, which is the bridge of skin/ tissue between the nostils. The scars that you are probably referring to are probably the scars that have resulted from 'Weir excisions'. These are generally curved scars that are placed at the junction between the outer nostril and the cheek. These excisions... more

Jay 1013, based on your description it appears that you had 'base incisions' used to narrow the width of the nose where it attaches to the cheek and upper lip. This is commonly done to address a flared nostril or a nose that is simply too wide at the base. If you don't see any sutures across the columella (the vertical column separating the left and right nostrils), you likely had a closed rhinoplasty approach. An open rhinoplasty approach involves an incision across the... more