What should I do for internal scar tissue in nostrils and dip rhinoplasty? (photos)

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

At one month you are still very early in the recovery process. Incisions inside the nose are not completely healed and there is still a significant amount of external swelling. The external swelling goes away unevenly and irregularly. I recommend allowing your surgeon to reassure you and to make a determination on whether steroid injections are indicated at this time. Best of luck. To be Andrew

Hello
and thank you for the question and sharing your photos. As you know, you
are still early in the recovery process. Generally speaking, steroids can be useful adjuncts in softening up scar tissue, but it would be up to your surgeon to decide on that. Rhinoplasty results evolve over
time and it would be hard to make a precise prediction of
how things will heal, especially not knowing what was exactly
done. Your surgeon is the best person to guide you through the healing
process and answer your specific questions. Best,
Pejman
Aflaki, M.D.
Johns
Hopkins-trained plastic surgeon

Thank you for your question.  It is difficult to tell from the photos where the scar tissue is.   It looks like you had an alar base reduction but I can not see scar tissue in that area causing obstruction.   A good intranasal exam could help determine where the obstruction is and if there is scar tissue that could be responsive to injection with steroid.   Depending on how the turbinates were reduced, it can take over a month for you to notice the difference and you can still feel obstructed in the early postoperative period.   From the base photo, I can see what looks like the vestibular skin at the level of the internal nasal valve.   If this is your concern, there are some procedures that can be done to open this area up but injected steroids would not help.   I hope this helps!
-Dr. Guy

At one month post op, what you are experiencing is normal.  It may be a little soon for a cortisone injection, but your surgeon will determine that at your exam.