Will Dark-skinned Patients Getting Septoplasty Have Unslightly Scars Around Nostrils? (photo)

Question

I am considering a septoplasty. I have seen some awful scars from septoplasty done on light-skinned patients: http://www.atlantaplastic.com/wp-content/gallery/septorhino-03/septorhino-03e-thick.jpg In that picture, the man's scarring is very apparent. I have dark-skin and I am worried that this would be potentially horrible for me since I could form keloids around my nostrils. Is this procedure safe for me? I have included a picture.

Paul S. Nassif, MD · Answer

There should not be external scars with a septoplasty, as the incisions are made inside the nose. In general, a small external scar is left during an open rhinoplasty. The goal is to make this scar minimally visible, and it heals rather nicely when the procedure is performed with precision. I would recommend doing your homework and seeking out a board certified surgeon who has a great deal of experience. This will ensure you obtain the best possible result. I hope this helps, and I wish you the best of luck.

Donald B. Yoo, MD, FACS · Answer

For a rhinoplasty, sometimes incisions are used on the outside of the nose. However for a septoplasty, to correct a deviated septum, all the incisions can be designed so that they are hidden inside the nose. Whether you have light or dark skin, the incisions will not be seen if properly designed.

Thomas A. Lamperti, MD · Answer

The photos you provided the link to show a rhinoplasty scar (across the columella) including alar base reduction scars (across the nostrils).

	A standard septoplasty places a hidden incision inside the nostril area so it shouldn't be visible. I've not heard of keloid scarring in this area.

	You can look at my web reference below to get a better idea where the septoplasty incision is placed and what surgery entails.

Matthew Bridges, MD, FACS · Answer

The photo you linked to showed poorly placed and poorly executed incisions. When incisions placed to reduce nostril width and flare are placed and executed properly, they should be very difficult to see (see link below for an example). Keloids from nostril reduction incisions are exceedingly rare (I have never seen it). Go see an experienced rhinoplasty surgeon and discuss your concerns.

Christopher J. Peers, MD · Answer

Since there are no outside incisions, there ought not to be any visible sign of surgery; so you should feel assured this is not likely to be a problem.

Garrett H. Bennett, MD · Answer

A septoplasty is correction of the deviated nasal septum inside the nose to improve breathing and sinus drainage. Most septoplasties are performed with incisions completely hidden inside the nose. Some surgeons may choose to make skin incisions in the columellar skin of the nose if they need to do a major septal reconstruction or flip the septum completely around in the nose, but this is very rare. More likely there was cosmetic or functional surgery of the nose, like rebuilding the external valves, that required greater access to the nose. Alar base reductions, removal of skin around the nostrils, are performed for cosmetic reasons only. Any skin incisions or even surgery under the skin that gets too close to the skin surface can cause scarring in anyone regardless of ethnicity.

William Portuese, MD · Answer

A septoplasty incision is located 1 cm inside the nose and is completely located inside with no external incisions, so there is no issue with a with the incision being being seen. A few are contemplating performing a rhinoplasty, consideration for close rhinoplasty technique whereby all incisions are placed inside the nose will completely avoid any keloid formation.

Andrew Rosenthal, MD · Answer

Septoplasty does not leave any external scars. Rhinoplasty (if done open or with nostril excisions will leave scars. These typically are very slight, are not prone to keloid, and are generally well hidden. The scars also can be treated with laser or other light therapies, but they will not completely disappear.

	I believe that despite the concerns of scarring, most noses in dark skinned patients are better addressed with open procedures. Most patients believe the mild scars are well worth the trade. This is particularly important because most dark skinned patients have poor cartilage or ligamentous support of the tip of the nose combined with thick skin which is better addressed with open procedures.

	If you are having a full rhinoplasty rather than just a septoplasty, make sure your surgeon is well versed in ethnic rhinoplasty.

Samir Shureih, MD · Answer

Pure septoplasty does not put any external scars. Open rhinoplasty will put a scar across the columella. usualy these scar fade within a year and are barely seen. if you do not want any scar then do not do rhinoplasty or do a closed rhinoplasty. Septoplasty incisions are insiide the nose.

Will Dark-skinned Patients Getting Septoplasty Have Unslightly Scars Around Nostrils? (photo)

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