Alar Base Scars After Rhinoplasty. What Are Some Treatment Options? (photo)

Question

Hello, Two years ago I had a closed rhinoplasty with alar base surgery.The right side alar base did not attach completely and there was scarring.After 9 months, the PS performed surgery on the area to remove the scar.The stitches were removed after 5 days and the area of the incision did not close at all but a large round bloody wound remained.It took about 2 months for the wound to close with sutures scars again.The PS said he can "cork" the scars.Can laser skin resurfacing treat these scars?TY

Howard Webster, MBBS (Hons), FRACS · Answer

Hi there,

	 

	It's rare to see poor alar base scars, so you are unlucky.  I don't think your ps has done a poor job.  Your skin looks thick, with deep pores, and olive in type? It's hard to be sure of that from your photo, so please excuse me if thats not correct, but it's the impression I get from the pic.

	This skin type has advantages - it ages slowly, and has an attractive appearance.  But it can scar poorly, especially around the nose.  I agree with the other surgeon who has answered your question.  I would not get laser resurfacing for this, I suspect it would make it worse.  I think a punch excision of the scars plus closure with a loosely tied very fine stitch removed within 5 days is the best chance of improving the scars. Another strategy we use for pale scars in my practice seems left field but works well:  tattooing them.  Our medical tattooist has had some success in coloring the pale scars which reduces their visibility.  It doesn't work for all scars - the shiny silver ones don't hold the pigment - but it works well for some and is worthy of at least a thought.

	 

	Good luck.

Raffy Karamanoukian, MD, FACS · Answer

Alar scars can be white and visible. Hidef protocols can help with visible alar scars on the face. I see a lot of these in my office in Beverly Hills. Surgery is often not needed if lasers and HIDEF scar revision techniques are introduced. 
In our office, we combine treatments starting with topical pre-conditioning of the scars with Plato's Scar Serum for hypertrophy and Melarase PM for pigmentation. Fractional RF, laser, and micro fractional RF can help limit scar growth. Kenalog IIT can also help reduce scar thickness. For lip lift scars specifically, I use selective Hyfrecation to reduce scarring. 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Ali Sajjadian, MD, FACS · Answer

Dear Anon,

	 

	Unfortunately, scarring due to the type of surgery you had is not that common but it seems that the thickness of your nasal skin contributed delaying your pace of recovery.

	Simply, laser skin resurfacing may be a possible option if the area of your scar were not at a difficult position to manipulate; your best bet could be a scar excision

	I encourage you to consult with your surgeon or with others of reputable certification and of extensive experience to be able to make a well informed decision based on their physical examination.

	 

	Thank you for your question.

	Best of luck to you.

	Dr. Sajjadian

Alexander Ovchinsky, MD · Answer

The scars after alar reduction may, unfortunately, be visible, especially in people with thick sebaceous skin.  I would consider laser resurfacing of the area.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

If he meant punch excisions, that's what I would do. Not a good area to laser. The punch excisions should do the trick.

Best,

Dr.S.

Alar Base Scars After Rhinoplasty. What Are Some Treatment Options? (photo)

Answers (5)

Answer: Scars after alar reduction

Answer: Scars after alar reduction

Answer: Alar Base Scars

Answer: Alar Base Scars

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Alar Base Scars After Rhinoplasty. What Are Some Treatment Options? (photo)

Answers (5)

Answer: Scars after alar reduction

Answer: Scars after alar reduction

Answer: Alar Base Scars

Answer: Alar Base Scars

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Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.