Alar base scar improvement - What are the best options? (Photo)

I have had a rhinoplasty 14 month ago, together with alar base narrowing. Now I am stuck with scars from the alar procedure. I have sebaceous skin, and blame that on the scarring. I am considering fractionated laser or dermbrasion but am concerned that my skin type could be a showstopper for these options. Would scar revision be a better option? What are your experience with my skin type and these procedures ? Thank in advance.

Doctor Answers 5

Alar wedge procedure

The problem is not the quality of the scars.  The problem is that the scar is not exactly in the crease.  This is an easy correction to undergo and could be performed under local,anesthesia in about thirty minutes.


San Diego Plastic Surgeon
5.0 out of 5 stars 25 reviews

Revising alar excisions is difficult.

Dear qube2100 in Los Angeles, California:

Those are difficult incisions. They are not quite in the ideal location. I would suggest consulting with dermatologists who specialize in surgical dermatology. Perhaps these can be gently shaved down using a variety of techniques, including laser techniques. I would not recommend another surgery. If it can be done at all by nonsurgical means, that is really what you should have. Look for somebody with a long run of experience in dealing with these. Some of the newer laser technologies are excellent. There are other techniques that possibly will be available to you, but certainly exhaust all nonsurgical means before considering any revision surgery.

Best wishes,

Robert Kotler, MD, FACS
Over 4,500 nasal procedures performed

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 83 reviews

Alar Base Scar Revision

It is almost better to have a formal scar revision and have the tissues make a new effort at creating a better scar. This is particularly true when the scars are not ideally in the alar-facial groove.

Alar base scar improvement

I agree with Dr. Bressler that your incisions are placed slightly too far outside of the alar groove. Several fractional laser resurfacing treatments or a single spot dermabrasion should dramatically improve these incisions. If this fails, a scar revision can be performed to "move" the scars closer to the groove where they would be better camouflaged. I hope this information is helpful for you.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Alar Base Reduction Scars

It appears that your alar base reduction incisions were placed too high and improvement may require a scar revision. 

Dermabrasion may offer you some benefit, and I would choose this before considering laser treatments. In my experience, your skin type should not be a major issue with dermabrasion. 

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon
5.0 out of 5 stars 7 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.