Possible skin graft for overdone alarplasty? (Photos)

Question

Please see pictures. Had sloughy tissue at the left alar, resulting to dehiscence, so the skin had to be recut resulting in a more short, unnatural left alar. I am so desperate right now. And until now I can tell the scabs once they fall off it will result to a deep scar. Can we do a skin graft from my ear or other areas? I just want this alarplasty complication to be over. Please help me.

Jacob Sedgh, MD · Answer

Judging from the pictures it might be too early to predict the outcome in this case. Once the wound completely heals and the scar fully matures the deformity might be a lot less noticeable and ameneable to less invasive modalities. I would be patient and wait for at least a couple of months before committing to another major intervention.

John Layke, DO, FACS · Answer

Firstly, let me preface this by saying that the nose has the remarkable ability to heal well and scars can often remain hidden despite the dehiscence that you suffered.  Rather than continually trying to cut out scars and remove tissue, it may be better to do something to improve the quality of the scar, such as microneedling, fractionated CO2 laser, or radiofrequency.  Post current photos so that we may give you accurate counsel.

Wayne F. Larrabee, MD · Answer

First you need to let this heal and do good wound care. This is an area that heals well by what is called secondary intention- just let it heal with time. If there is significant asymmetry or irregularity of the ala after healing there are a number of ways to improve it- from composite grafts of the ear to skin resurfacing.  For now it is difficult to be patient but just let it heal.

Jeffrey Jumaily, MD · Answer

Dont think you need more surgery at this time. I would let this heal on its own for a few months, perhaps a year before doing any revision. Removing tissue from the nose can result in unnatural stuck on appearance. Best wishes

Possible skin graft for overdone alarplasty? (Photos)

Answers (4)

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