Visible, uneven rhinoplasty scar - Scar revision or laser/steroid injections? (photo)

Question

I had a procedure done a few years ago for asymmetry and breathing concerns. I now have a very visible uneven scar which concerns me. Will I need a scar revision or would laser/steroid injections be enough?

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your concern and photo. Based on your description, both approaches—scar revision and non-surgical treatments—can be considered depending on the nature of the scar.

If the scar is raised, red, or thickened (hypertrophic/keloid): steroid injections and/or laser treatments can help soften and flatten the scar while improving its appearance.

If the scar is uneven, irregular, or poorly aligned with the surrounding skin: a surgical scar revision may provide a more definitive improvement by re-excising and carefully re-closing the area for a smoother result.

Sometimes, a combination of both surgical and non-surgical treatments is recommended to achieve the best cosmetic outcome. The choice depends on factors such as the scar’s location, thickness, color, and how it has healed over time.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Visible, uneven rhinoplasty scar - Scar revision or laser/steroid injections? (photo)

Answers (2)

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