How to get rid of an alarplasty scar? (photo)

Question

I had a rhinoplasty a few years ago and had alarplasty scars that my surgeon was not successful in hiding in the creases of my smile line. He went back in a year later to revise my scar but it still makes my smile look unnatural and my smile lines uneven. I've gone back to his office several times for Fraxel lasers, waiting 3-6 months in between for it to heal, but it hasn't been successful. Is there anything else I can do to fade the scars and make my smile lines symmetrical?

Zoran Potparic, MD · Answer

It appears that you have a thick, irregular scar which is frequently seen in this area in particular with patients who have thick, oily skin. Dermabrasion using fine diamond burr may be more efficient in shaping and flattening this scar than laser. Good luck.

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

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Based on
your photographs, you may benefit from a surgical scar revision of your alar base.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Benjamin W. Cilento, MD · Answer

Hi
   thanks for posting pictures. It looks like your scars are thickened and irregular. They would respond better to dermabrasion and or fractora than to traditional lasers. Hope you find your way to a good surgeon.
DrC

Greg Bran, MD, PhD · Answer

Hi there and thank you for the pic. Based on your photo, there are two ways to make your scar less noticeable: a non-surgical way and a surgical way. The non-surgical way would include the combination of steroid injections and dermabrasion. You will probably need two cycles to improve the appearance of the scar. The surgical option would be a resection of the old scar tissue and a new alignment of the skin envelope. This can be performed with local anaesthesia. 
Regarding your smiling, you need to discuss the changes you have observed with an experienced rhinoplasty surgeon before evaluating, if any of the discussed procedures would help you.
Good luck!

How to get rid of an alarplasty scar? (photo)

Answers (5)