CO2 laser for rhinoplasty scars - what to expect? (photos)

Question

After rhinoplasty I was left with visible alarplasty scars. During revision 6 months ago surgeon tried to improve my alar bases, causing even more visible scarring and q-deformity below my nostrils. Now he wants to try to improve scars below and side of my nostrils with CO2 laser. I would love to get more opinions before saying yes. Could laser make the scars worse? My doc says no but I´m not convinced. What can I expect from healing of this? What are possible complications? Any other options?

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

Jason Emer, MD · Answer

This scar can be improved with laser spot treatment, fillers, microneedling/prp and subcision to help texture and blending. I recommend getting a formal evaluation with a scarring expert. Best, Dr. Emer

P. Daniel Ward, MD · Answer

Thank you for the question. Lasers can be used to produce collagen, which can help fill in the scars. The laser will not remove the scar, but it will make it less visible. Good luck!

Jeff Rapaport, MD · Answer

Lasers  don't lift scars. Your alar scars are depressed and tethered.  A combination of subcision with a permanent filler such as bellafill would be helpful. Fractionated low-density laser can be performed at a later time, if needed. Find a scar expert. Ask to see photos.
Jeff Rapaport MD
Core Aesthetic Realself

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