"Bunched/bunching" Very Noticeable Upper Alarplasty Scars and Uneven Alars: Can These Still Be Fixed? I'm Very Unhappy. (photos)

Question

I've already had these scars for a year 'cause of a failed primary alarplasty (the 3 photos - bottom portion of the collage). After a year, had the scars revised, (3 photos - upper portion) My question: 1. My PS told me to wait for a year "to see if we should still revise it". Obviously I need it. Can the bunched scars still be fixed? I've had them before but he didn't COMPLETELY remove it, he says HE DID, if he did then why's it still there? He's saying it will flatten? The scars didn't before

Jeffrey Joseph, MD, FACS · Answer

I would consider any scar gel used daily in these areas and proceed with deem abrasion. Hope this helps.

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

John Layke, DO, FACS · Answer

Many times alar base reductions are not taken up as high in the crease.  I would recommend using a scar gel for a few months.  At the 3-6 month period, mechanical dermabrasion can be performed to help "sand" the area and mask the irregularity.  Discuss options with your surgeon.

Benjamin Chu, MD, FACS · Answer

When the alar is reduced it is not advisable to cut along the side of the alar.  The scars are much more visible.  You case is a prime example of this.  The second is the sutures have been left in too long.  Sutures should be removed by day 4-5.  Leaving sutures you end up with "railroad track" marks.  Of course how good the scar looks is related to how precise the incisions were sewn together as well as how the individual scars.  Your case would need to wait to see how the scar looks after it settles and then reconsider revision.

David Reinstadler, MD · Answer

I'm sorry you are dealing with this situation. Since you are relatively early in the healing process at this point, I would give it some more time. I would use a scar cream of some kind as well as consider laser treatments in the upcoming months to improve healing. Continue follow up with your surgeon. Best of luck

"Bunched/bunching" Very Noticeable Upper Alarplasty Scars and Uneven Alars: Can These Still Be Fixed? I'm Very Unhappy. (photos)

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"Bunched/bunching" Very Noticeable Upper Alarplasty Scars and Uneven Alars: Can These Still Be Fixed? I'm Very Unhappy. (photos)

Answers (9)

Answer: Alar reduction do's and don'ts

Answer: Alar reduction do's and don'ts

Answer: Alar scars

Answer: Alar scars

Browse related questions

Recommended reading

Everything you need to know about Alarplasty

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