What Kind of Treatment Do You Suggest for my Alar Base Scars? (photo)

Question

I had rhinoplasty with alar base reduction in Feb 2012. Didn't like the nose job from the start. I dont have a hump anymore but my nose still looks bulbous (which was my main concern) and the scars are very visible. I'm not sure if I'll be needing a revision.

Raffy Karamanoukian, MD, FACS · Answer

Alar scars can be white and visible. Hidef protocols can help with visible alar scars on the face. I see a lot of these in my office in Beverly Hills. Surgery is often not needed if lasers and HIDEF scar revision techniques are introduced. 
In our office, we combine treatments starting with topical pre-conditioning of the scars with Plato's Scar Serum for hypertrophy and Melarase PM for pigmentation. Fractional RF, laser, and micro fractional RF can help limit scar growth. Kenalog IIT can also help reduce scar thickness. For lip lift scars specifically, I use selective Hyfrecation to reduce scarring. 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jamil Asaria, MD · Answer

Your best option for trying to improve the scars after alar base reduction would be to try dermabrasion. This treatment under local anesthesia can help to soften the appearance of the scars after your rhinoplasty.

	Dr. Jamil Asaria

	FACE Cosmetic Surgery

	Toronto Canada

Toby Mayer, MD · Answer

Alar scars and bulbous droopy tip can be revised and you should wait at least 3 more months. The alar scars made in that location almost always heal poorly sue to oily skin of that area.

Sam Naficy, MD, FACS · Answer

Based on your photos it appears that you would be a good candidate for revision surgery, but an in person examination would be essential. The scars can be treated with dermabrasion or laser resurfacing. You can also benefit from a major columellar strut or septal extension graft

Michael R. Menachof, MD · Answer

The best option (and fairly non-invasive) is to find someone in your area with the Icon laser from Palomar and have them use the 1540 XD hand piece on your scars. 3 or 4 treatments will likely give you a great result. Scars in this area have been a problem for us for a long time. This laser, with this hand piece, in the right hands, has been the single best advance in scar treatment during my 20 years in practice. As far as a revision to the nasal tip goes, I would probably wait another 3-4 months to make sure that all of the swelling has resolved before you think about having it revised. The sooner you treat the scars, the better the results will be. Good luck.

Darryl J. Blinski, MD · Answer

Thanks for the posted photos. In my opinion why wait it has been 7 months+/- so if you desire a revision than OK to try to get one

Richard W. Fleming, MD (retired) · Answer

I recommend that you wait another 3-6 months to revise the alar base scars refine your bulbous, hanging tip. Over the past 35 years I have learned that we should wait until healing has progressed.

Daniel Greenwald, MD (in memoriam) · Answer

Scars in this area mature slowly and often are less than optimal because of the oily nature of the skin there. It is a bit unusual to have such scars after cosmetic rhinoplasty; it would be interesting to see your pre-op pictures. For now you should wait until the scars plateau in their maturation. See your surgeon every 6-8 weeks until the scars stop changing, then have a revision.

What Kind of Treatment Do You Suggest for my Alar Base Scars? (photo)

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