Scar tissue is causing columella asymmetry. How would scar tissue be accessed and removed during a closed revision rhinoplasty?

Question

Hello, doctors. I have a question concerning how access to the columella, specifically to the area underlying the columella skin, is obtained during a closed rhinoplasty. One of my revision rhinoplasty issues includes a hard lump of scar tissue that formed under the columella area that causes my columella to look asymmetrical and skewed and was not addressed during my primary rhinoplasty. How might this scar tissue mass be accessed and removed through a closed revision rhinoplasty?

Tanveer Janjua, MD · Answer

It is possible to improve the columella by removing some of the scar tissue. A closed approach can achieve this. However, symmetry is hard to achieve. 
Regards
Dr. J

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Scar tissue is causing columella asymmetry. How would scar tissue be accessed and removed during a closed revision rhinoplasty?

Answers (2)