Surgical Scar on the Nose? (photo)

I have managed quite a few scars on the nose in the course of my career. Most resulted from dog bite injuries, other forms of trauma, and acne.

The photos suggest a more linear scar. Although some might suggest excising, for relatively small, line-like scars, I would suggest a series of subcision treatments. Surgical excision in the tight confines of the nose risks creating an even bigger scar from spreading.

Subcision is a simple procedure that uses a needle-like cutting device that is slipped under the scar (under local anesthetic) and moved from side to side in order to break up the fibrous bands of scar tissue. This allows for the surface of the scar to float to the surface and also to promote new, more normal collagen synthesis to fill the potential space created. The result--a much more shallow scar and often significant visual improvement.

If there is an unsightly surface texture to the scar, or if its off-white color remains disturbing, a series of medical microneedling treatments can be initiated. For small scars, the DermaStamp can be used. This is a small instrument with a series of sterilized needles attached, which may be used, under local anesthesia, to disrupt the surface of the scar. allowing it to reform in a more uniform texture and sometimes color.

Alternatively, the Punctuated Phenol Peel technique may be used. With this technique, also performed as a series of treatments, microdroplets of full strength phenol are placed along the scar--leaving intervening untreated spaces (a fractionated approach) from which healing may take more rapidly and with less risk for actually causing a scar. 

Most often, I have found that subcision performed alone or combined with medical microneedling is capable of producing quite a gratifying aesthetic improvement. 

 

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

Your scar on the nose is in a very difficult place to correct.  The safest course of action would be to have Restylane injected into the scar.  If you elect to have any surgical procedure you are at risk of making it worse.  Please find an experienced board certified dermatologist with cosmetic surgery experience in your area .

The tip of the nose is a very tricky place to operate. Anything surgical will create additional scarring. Possibly filler could be used to improve the depression.