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

Question

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.

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

Ronald J. Edelson, MD · Answer

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.

Stephen Weber MD, FACS · Answer

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, FACSDenver Facial Plastic Surgeon

Robert Kotler, MD, FACS · Answer

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

Barry L. Eppley, MD, DMD · Answer

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 - What are the best options? (Photo)

Answers (6)

Answer: Revising alar excisions is difficult.

Answer: Revising alar excisions is difficult.

Answer: Alar Base Scar Revision

Answer: Alar Base Scar Revision

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

Answers (6)

Answer: Revising alar excisions is difficult.

Answer: Revising alar excisions is difficult.

Answer: Alar Base Scar Revision

Answer: Alar Base Scar Revision

Browse related questions

Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.