I have a big visible scar after rhinoplasty. Can it be fixed? (Photo)

Question

I had rhinoplasty 7 month ago and all this time I had big visible columella scar . Doctor said is will go away with swelling but it didn't . Now my doctor says that he can fix it now and it's not hard procedure but I am very afraid to go to the same doctor again . This is gonna be my 3rd surgery on my nose with him . I am not sure if it didn't heal right , or did I do something to cause the scar and maybe it's doctors fault . It affects my life tremendously and I wanna get it fix asap .

Toby Mayer, MD · Answer

Visible scar after open rhinoplasty?  The scar can be excised and the edges properly closed. This will leave and almost invisible scar versus what you have now. At the same time you're hanging columella can be repaired as well. Discuss

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Gerald Minniti, MD, FACS · Answer

Hello,You would benefit from a scar revision to better re-approximate the edges of your incision so they are flush.  This will lead to a virtually invisible scar. This is can be done quickly under local anesthesia.Best of luck!

Sirius K. Yoo, MD · Answer

Thank you for your question and photos.  Your scar is atypical not what should be expected from external approach rhinoplasty.  A scar revision is certainly in order.  The result should be an imperceptible irregular line and not the step-off that you currently have. If you have a good rapport with your surgeon and trust him, the procedure is relatively straight forward.  Otherwise, seek a second opinion from someone in your area with a good reputation.  All the best!

Marcelo Ghersi, MD · Answer

Hello. I agree with your surgeon in that this is a relatively simple issue to fix. However, you must feel comfortable with your doctor, prior to letting them operate on you. Follow your gut and do your research to make this decision.

Jeremy B. White, MD · Answer

Your scar can be fixed with a small office scar revision under local anesthesia. Keep a close eye on it postoperatively and use a silicone gel once you have the doctor's ok after suture removal.

Theodore Nyame, MD · Answer

Thank you for your question. A scar revision should be all that is required to correct this scar. Best wishes

Fred J. Bressler, MD, FACS · Answer

Thanks for your question and photos. You could benefit from a simple scar revision to improve the appearance of your columellar incision. These types of problems are not common, but can occur from time to time even in the best of circumstances with excellent surgeons. It sounds like your doctor shares your concern and wants to help fix this. If your surgeon continues to have earned your trust and you feel comfortable with the doctor's plan for scar revision, then consider scheduling your procedure. Best of luck.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Your current deformity was created by poor repair of your columella incision; this can easily be fixed in the office with local anesthetic; repair of this incision requires precise reapproximation of the incision line and closure in two layers in order ensure that you have a smooth rather than step deformity of your incision.

Michael Elam, MD (retired) · Answer

Dear Hannah2016h, Personally when I use an open approach I prefer to make the incision an inverted incision not a straight line so that you can approximate the edges perfectly allowing for no visible sign of incision typically within ten days of the patients recovery. At this point you need a scar revision to do exactly that. In expert hands this is a fairly straightforward procedure. Best regards, Michael V. Elam, M.D.

I have a big visible scar after rhinoplasty. Can it be fixed? (Photo)

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