Columella lumps scars after open Rhinoplasty complications/scars/bad stitches? What is this? What can be done? (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

You should see a rhinoplasty surgeon and have them evaluate the nose. Could be several things, infection(bacterial or viral), suture reaction, allergic reaction ,foreign body reaction, to name a few. No revision until this active problem is resolved and settled down. May have to wait for a year.

This is definitely unusual. It is possible you had a hematoma below your incision or some infection. This will likely need to be revised but you need to heal for at least 6 months prior to that procedure. Depending upon how you heal in the next couple of months you might be a candidate for laser resurfacing. Your healing process will determine which approach is best. I would send your surgeon photos and discuss with them now as the incision healing is not going as planned. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

The scarring on the columella is extensive.  There is a possibility that an infection happen after the surgery which could be either bacterial or viral such as Cold sore virus.That can lead to extreme scarring.She needs to be evaluated and it would be a long process in trying to fix the scar.  It will require revision surgery followed by possible injections of steroids.RegardsDr. J

Thank you for sharing your question and pictures.  The appearance of the columellar scar concerns me, and I think you should either see your surgeon or a local surgeon to evaluate it.  While you would not be eligible for revision surgery this soon, it is important that you have it looked at sooner rather than later.  I hope that is helpful.All my best!Dr. ElizabethElizabeth Whitaker, MD, FACS"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Although it is impossible to comment on your surgeon's work without seeing pre-operative photos as well as an operative report detailing the maneuvers that were surgically performed, I am concerned that you may be developing a hypertrophic scar, or possibly even a keloid, on your columellar incision. Because you had surgery outside of the country, it would be very valuable to obtain any operative diagrams from your surgeon to allow your American rhinoplasty surgeon to properly evaluate and monitor your recovery. I would also strongly recommend that you bring in pre-operative photos for comparison. At only 4 weeks, it's clear that there is still significant swelling, and there is much that will still change, especially with regard to the nasal tip. Your new surgeon should inspect the tip to determine how much scar tissue is developing in the area above the tip as well since you appear prone to excess scar tissue formation. Early treatment of excessive scar tissue formation, both in the tip and on the incisions, is critical to ensure this atypical healing is kept to a minimum. I would recommend that you see a board certified plastic surgeon with rhinoplasty training and experience for management of these potential issues and for consideration for possible steroid injections. Best of luck!