4 weeks post op, what can I expect from columellar scar? (photos)

Question

I am 4 weeks post external rhinoseptoplasty. Immediately after surgery, I noticed the sutures on one side of the Incision line were not as well-approximated and tight. The incision line was a little edematous a few hours to days following, which caused the tissue to extend pass the sutures. I now have this notched appearance to my scar. What can I expect as a final appearance and Are there any interventions for this type of scar. Thank you

Andrew S. Frankel, MD · Answer

The flap of columellar skin was elevated and the skin posterior to the incision (closer to your lip) was not. Thus the former skin is swollen and the latter is not. Therefore there is a slight 'step' at the incision line and this is due to swelling. All incisions look their worst around 6 weeks post operatively so I feel things will ultimately look just fine. Follow up with your surgeon as there are several adjunctive things that might be helpful if there are concerns such as laser, silicone sheeting or gel, kenalog injections, steroid impregnated tape etc...

Remus Repta, MD · Answer

Thank you for the question and the photos.  Most incisions look at their worst right about 4 weeks since collagen buildup its at its highest right around then.  Swelling is also a factor for you since your columellar incision is a little closer to the lip junction than usual and therefor further from its blood supply.  I think in the end the incision is going to heal quite nicely.  It may take a little longer than usual but definitely know that quite a bit of time is needed for significant healing to occur.All the best,Dr. Remus Repta

Michael Elam, MD (retired) · Answer

Dear Jodizjz, Personally I make my external incision notched (not straight) and higher on the columella towards the tip, not so close to the lip junction for better healing. This incision typically heals very well and is unnoticeable to most eyes after a few weeks recovery. I would follow up with your surgeon and discuss your concerns and he/she can monitor your recovery closely. Best regards, Michael V. Elam, M.D.

Robert E. Zaworski, MD (retired) · Answer

In the vast majority of Rhinoplasty cases, the columellar heals extremely well.  Follow up with your Plastic Surgeon in the next couple of weeks to address your concern.

4 weeks post op, what can I expect from columellar scar? (photos)

Answers (4)

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