Scar deformity after open rhinoplasty. What is the solution? (Photo)

The columellar scar from a rhinoplasty can be tough to treat. The best option at this time would be a scar revision with eversion of the skin edges followed six weeks later by dermabrasion.RegardsDr. Janjua

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

The columella scar is tough to get perfect. If you'd had CO2 laser resurfacing, the. I think the next step is to re-excise scar and re approximate it. Part of the columella looks depressed. So a plumping graft might be helpful to further camouflage that area. An in office so silt is always helpful to decide exactly what you need. 

Scarring at the columellar incision site can be a difficult problem, as this area is a very specialized type of skin.  If you have tried CO2 laser without improvement, I may consider mechanical dermabrasion to attempt to "sand" the skin achieving a smoother surface.  

Thanks for your question. That's a tricky problem. I don't think that CO2 lasers or silicone gel will help in this case. Both are excellent options for scars, but they have limitations. I think that a surgical scar revision would probably suit you best- have the old scar removed and a new closure. If there were other things that you disliked about your nose, they could be fixed at the same time. Most rhinoplasty surgeons should be able to achieve both of these goals. Good luck.