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

I had an open rhinoplasty 11 days ago. This morning I've replaced tapes and I'm shocked by the scar. It is irregular, and on the right side seem that a piece of skin is missing. I feel really bad about this will improve or there's no way? I will see my doctor only on Friday. Thanks in advance.

Doctor Answers 14

Columella Scar - I'm Worried About It?

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. 

Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Columellar scar

You definitely have a poorly aligned skin edge when the closure was performed thus making the scar look obvious but this is compounded by the fact that the caudal end(lower end) of the septum is deflected to the right and into the right nostril.  The scar should be revised but not for at least 3 months to allow healing to occur from the original surgery and the possibility that it may improve.  In 3 months both the scar and the septum can be corrected to correct the present deformity.

Devinder S. Mangat, MD, FACS
Cincinnati Facial Plastic Surgeon
3.8 out of 5 stars 27 reviews

Unusual nasal scar post-rhinoplasty - Dr. Marc DuPere answers...

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

Marc DuPéré, MD
Toronto Plastic Surgeon
4.8 out of 5 stars 62 reviews

Columllar scar after rhinoplasty

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. 

Matthew Bridges, MD
Richmond Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Columella Scar after 11 Days

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.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 68 reviews

The appearance of this columella is worthy of concern.

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.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Columellar Scar

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.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 reviews

Columella Incision

   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

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Columellar scar

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. 

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Columellar scar problems

This is not what the usual columellar scar looks like even early on.  I'd suggets that you contact your doctor today and either be seen or at least send in these photos for them to evaluate.  They may want this to heal and then do a revision.  It all depends on what was needed and what was done.  But if you chose an excellent doctor they'll get you through this.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.