Atrophic scars after 2 rhinoplasties - how can I treat this? (PHOTOS)

Hi, thank you for sharing your detailed history and photos. I can hear how frustrating and discouraging this has been for you, especially after trying multiple treatments without noticeable improvement. Your situation is complex, but there are some key considerations and approaches that might help.

1. Underlying Tissue Quality:
With multiple surgeries and a potential diagnosis of Ehlers-Danlos syndrome (EDS) hypermobile type, your skin and connective tissue are more fragile and prone to poor healing and scarring.

Reduced blood flow, as you’ve noticed with coldness in the nose, can further compromise regenerative potential and collagen remodeling.

2. Challenges With Standard Treatments:
Treatments like PRP, microneedling with collagen or nanofat, Fraxel, and CO2 lasers rely on healthy tissue response and blood supply. In your case, limited circulation and fragile connective tissue may explain the minimal results.

3. Possible Approaches:
Platelet-rich or stem cell–based therapies can still be considered, but their effectiveness may be limited unless tissue perfusion is addressed.

Surgical revision with structural support: In some patients with EDS and multiple prior rhinoplasties, adding grafts or autologous cartilage/fascia to support the nasal structure can improve contour and reduce atrophic appearance.

Tissue engineering or regenerative scaffolds: Advanced centers may use biocompatible matrices to stimulate tissue growth in scarred areas. This is still specialized and individualized.

Protective and supportive care: Keeping the tissue warm, avoiding trauma, and gentle massage (if safe) can help maximize any regenerative attempts.

4. Setting Expectations:
Because of your EDS and prior surgeries, completely “normalizing” the tissue may not be possible, but careful, targeted regenerative or structural approaches can improve contour and reduce the appearance of atrophic scars.

Working with a surgeon or dermatologist experienced in post-rhinoplasty reconstructive care for connective tissue disorders is critical to avoid further tissue compromise.

I understand how discouraging this feels, and it’s valid to seek a solution that truly regenerates tissue rather than just superficially treating it. Your case is complex, but with a thoughtful, individualized approach, there may still be meaningful improvement.