Columella Scar - I'm Worried About It? (photo)

Thank you for your question.  I must say it does look more irregular than most normal average columellar incisions.  Please see your plastic surgeon to rule out opening of the wound - dehiscence - or infection.  Rhinoplasty scars can be light red and swollen at 10 days post-op but should be fairly well aligned.  Good look!  Dr. Marc DuPere, Toronto Plastic Surgeon, board-certified  416.929.9800

Even though it is early in the healing process for your columellar incision, I must say that it looks more irregular and asymmetric than I am used to seeing.   I would have your surgeon examine this immediately to make sure there is not an infection/abscess/hematoma or otherwise. 

Generally it's unwise to make judgments about healing nose for weeks after an operation. In this case the asymmetry is bothersome. It looks as though some of the cartilages in the columella may be eccentric. I would talk your plastic surgeon to get a hands-on opinion and some reassurance.

On the positive side, columellar skin usually heals almost imperceptibly.  So much so that I have never had to revise one of my scars.  However, the base view shows irregular swelling, possibly related to deflection of the caudal septum.  I would definitely raise these concerns with your Surgeon, although he/she is likely to advocate (correctly) a watch and wait policy until the swelling subsides.

   The appearance of your columellar closure is concerning.  Go in to see your plastic surgeon for an exam to determine what is the next step.  Kenneth Hughes, MD Los Angeles, CA

I would contact your surgeon and have your incision evaluated in person at this time.  The incision does not appear like it is healing normally at this point. 

Are you a smoker?  If so it's important to stop completely during your recovery.  Your incision line appears to have separated a bit on the right side.  Follow up with your surgeon asap.  Things like hyperbaric oxygen may help with the proper healing of the wound.  

This is not the typical appearance of a scar even at this point. You should have your surgeon take a look at it and discuss options. Most likely you should let it heal for many months then come back and have it revised. 

I have read all the expert responses and I will interpret them a bit differently. I believe you need a revision of the columella incision. Either the closure was NOT "lined" up properly, or a dehiscence has occurred, or as Dr Prendiville stated the caudal edge is out of line causing the appearance of an uneven closure, or a combination of these effects. Either way see you surgeon ASAP to understand this issue and determine a plan for correction. Whether it will be observation of the stages of healing to see if there is any improvement or an immediate surgery to correct is up to YOU and your chosen surgeon (I hope he/she) was a boarded surgeon. 

At 11 days after surgery, it is not wise to judge your scar due to swelling. Most columellar scars are irregular and commonly have a "stair-step" appearance. It will improve in a few weeks.