Is it worth risking getting my bossae removed by external incision? What is the likelihood it will return? (photos)

The external incision in  rhinoplasty is performed on the columella which is the thin tissue between the two nostrils. This is referred to the external approach in comparison with other  approaches. One of the advantages of the external approach is to give the surgeon the best exposure to perform maneuvers on the nasal tip. This could be particularly helpful in cases of revision rhinoplasty that require correction of tip asymmetries. Once this incision is closed meticulously by an experienced rhinoplasty surgeon the scar is almost always imperceptible in a few months.

For revisions to correct issues like a bossa, I would consider going to experienced rhinoplasty surgeon but not to just discuss surgical options, but to discuss non-surgical options like fillers to improve this.  If surgery is your only options I would recommend doing an open rhinoplasty with incision under the nose.  Internally the work is to soften the bossa or to add cartilage to it but not to remove more cartilage.  Best Wishes!!

Go here to see where the "columella" is, and where the incision should be:FacialSurgery.com/ClkoffTPgt3_2011_01_01bh.htmlAn incision should never ever be made right over the bump itself.Also, correcting a bossa or a bump like that is rarely a simple procedure. Make sure your surgeon is expert enough to correct the problem. Click on the "Web reference" link, just below my response, and read the section on how to tell whether your primary surgeon should be performing your revision.

 You're up close nasal photo appears to show thin nasal skin. Thin nasal tip skin is unforgiving after rhinoplasty surgery and can reveal irregularities in the underlying tip cartilages more so than in those who have thick nasal skin . To improve this condition, revision rhinoplasty may be indicated, however, other irregularities may arise in the future when your post surgical swelling resolves. Consider consulting with several revision rhinoplasty specialists so you could see what might be best for you moving forward. Hope this helps! Dr. Joseph. 

Thank you for your question.  Most likely, your surgeon is referring to an external excision which is across the columella of the nose.  This is the bridge of tissue which sits between the nostrils.  This incision, when meticulously closed, will leave an imperceptible scar.  With this incision, your surgeon will perform an open procedure, where the cartilages can be reshaped and the bossae removed.  There is also a 'closed approach', where all incisions are made on the inside of the nose, as well.  Be sure to consult with a board certified facial plastic or plastic surgeon who specializes in rhinoplasty for a full evaluation.  I hope that this helps!-David Gilpin 

Bossa which can occur from rhinoplasty can be revised with shave excision.  Your Dr may mean that they plan to use an external incision used  for external rhinoplasty surgery.  This scar is across the columella.  In certain situations a surgeon can correct a bossa with a closed rhinoplasty procedure where the incisions are all from the inside of the nose.

Thank you for the question and photo.  Although direct excision is possible it will leave a visible scar on the tip of the nose which is not ideal.  A formal rhinoplasty revision to shape and contour the cartilage(s) is ideal.  Although that is more work it will inevitably be a better option if avoiding a scar on the tip of the nose is preferred.Good luck with your surgery.Dr. Remus Repta