Indented scar on Nose - what can I do to fix this? (photos)

Question

I've had an indented scar on the middle of my nose for 4 years. It happened from falling outside and hitting my nose. A couple years ago I tried 3 sessions of microneedling but it didn't seem to help. A doctor suggested a filler, but I read those are risky on the nose. Would any topical treatments such as retinoids help? Should I try microneedling again? I don't want to waste more money.

J. Timothy Katzen, MD, FACS · Answer

Hi emily30, thank you for your question about the scar on your nose and the best treatment for this scar. I believe a Fraxel laser would be best for this scar. Microneedling could help, but it may require more treatments.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Afternoon! Scars on the nose can be tricky. If you've tried microneedling, I would seek an alternate route. If the scar is deep and tethered, subcision may help to release it. At the same time, I will inject nanofat. This fat from around your belly button has growth factors and stem cells which are excellent for healing. It may require multiple injections and treatment. I agree that fillers can be risky within the nose if not done carefully. It's possible that retinoids may help but I would doubt substantially. A last resort would be excision to try and make a "better" scar. Hope this helps you!

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