Solution to webbed canthus after botched nose job? (Photo)

Question

Closed rhinoplasty went wrong. I was told the chisel "slipped" and cut me from the inside out and came out of my tearduct. I am prone to hypertrophic and keloid scarring. I used silicone gel the second I could religiously. At first the wound was healing, however it has now become tighter and more webbed everyday. The hypertrophic scar is so webbed and hard that it is pulling my inner tearduct in messing up the shape of my eye. I am 1 and 1/2 months post op, and the scar only grows more angry.

Oakley Smith, MD, FRCSC · Answer

Sorry to hear about your unexpected scar after rhinoplasty. It's a rare problem, but does happen unfortunately. The treatment is medical and conservative at this point. Steroid injections, taping and use of a scar gel are all possibly useful to improve the outcome. The decision to operate should wait until a year has passed. Perhaps even longer depending on the degree of maturity of the scar. If the scar tents up, which is a possibility as the scar contracts, then a form of Zplasty to lengthen the scar can help it settle down and smooth out.

Ege Ozgentas, MD · Answer

Hello natethegreat880. Sorry for this annoying situation. If your tear duct is intact don't worry. If you don't have tear drops rolling always down from your left eye that means your tear duct is intact. 1,5 months after operation is very short time for scar maturation. Wait for up to one year or more. Usually after 3 months scars begin to get softer. Steroid ointments, silicone gels and some laser beans may accelerate scar softening. However even you do nothing special most scars softens by time. I wish you a quick recovery. Good luck.

Tamir Mosharrafa, MD · Answer

At this point, scar massage is the most appropriate step. The scar will likely relax and soften over time. If the webbing persists beyond a year, a Z-plasty will correct it. Good luck.

John Harbison, MD · Answer

I am sorry to hear about your situation.  This can be a difficult area to treat, but as you are somewhat early in the healing process there are some options.  I think if you keep noticing worsening and tightening of the scar you may benefit from some steroid injection, and possible 5-FU to help breakup the scar.  These medications have to be used very judiciously around the eyes.  I also recommend aggressive massage to help breakup the scar, help minimize further changes.  If these do not adequately address the problem, and they may very well may not, you could look into scar revision and possible M-plasty of Z-plasty to help with the webbing.  I would try the least aggressive options first given how early it is, and your history of hypertrophic scar formation.

Solution to webbed canthus after botched nose job? (Photo)

Answers (4)