Options for Treating External Rhinoplasty Scar?

I had rhinoplasty in Sept '08. The surgeon cut thru a small spot on the tip of my nose and I had a couple of very small sutures. As my nose healed, there was a noticeable raised scar that did not respond to multiple injections.

I am hesitant to allow my surgeon to do any additional procedures to correct the scar but would like to inquire regarding options. Can you please tell me what options are available for smoothing or erasing the scar?

Doctor Answers 8

Treatment for external rhinoplasty scars

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The only option for treating scars on the tip of the nose is dermabrasion. to the actual scar itself. If it is a depressed scar, a small cartilage graft placed underneath it would help build it back up. The open rhinoplasty scar can be addressed sometimes by trimming back the membranous and cartilaginous columella to prevent columellar show, which will not allow the incision to be noticed.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Scars respond to injections and laser

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These hypertrophic scars typically respond very well to injection of low dose corticosteroid and 5-fluoruracil. The addition of pulsed dye laser treatments (such as the vbeam) can further enhance results. Additionally laser treatments with a non-ablative or ablative fractional laser (such as fraxel) can be very helpful as well. Ususally I start with injection and laser and then 2 weeks later repeat the injection and then 2 weeks after that do both laser and injection and continue with this schedule until significant improvement is noted. It looks like a very treatable scar to me.

Elizabeth F. Rostan, MD
Charlotte Dermatologist

Treating external Rhinoplasty scars

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From your picture it appears you have a hypertrophic scar. Using an injection of kenalog a steroid should be helpful. Usually 3 to 5 injections separated 6 weeks apart are necessary to get the full benefit. After that I would consider lase skin resurfacing for the scarring depending upon the way it looks or doing a removal of the scar with re-suturing. But start with the steroid shots.

Andrew Jacono, MD
Manhattan Facial Plastic Surgeon
4.7 out of 5 stars 215 reviews

Correcting External Nose Scar

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You appear to have a hypertrophic nasal scar. With your skin type (Type I or II) one would expect the scar to be barely noticeable by now after 1.5 years.

The approach would depend on your risk tolerance. While intralesional steroid injections could flatten the scar - they could also result in a wide and depressed scar.

Another option may be planing the scar down with a laser such as the Sciton Joule and treating it with its ProFractional option.

Finally, you may even want to consider scar revision which may result in a better scar.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Treatment for nasal scar.

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If you have already had Kenalog injections that did not work, then you should have a consultation with an experienced rhinoplasty surgeon to determine if there was to much tension on the suture line and whether revision would result in a better scar.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

External rhinoplasty scar

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This scar usually heals very well, but if it does not, steroid injections are helpful. Laser treatment might reduce the scar as well, but I would recommend seeing someone very skilled at this. Finally, scar revision can be done to excise the current scar, but keep in mind that this in turn creates a new scar. Good luck.

Thick scar on nose: Brief overview of options

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The use of kenalog steroid injections is the mainstay of hypertrophic scar management. Secondary to this the use of topical scar massage, pressure therapy, and topical silicone sheeting are traditional adjunctive procedures. Less commonly used but other potentially beneficial modalities include the use of laser therapy, IPL treatments, Infrared coagulator, dermabrasion or skin needling. Even less commonly and somewhat controversial off label interventions include the use of Aldara, 5FU and collagenase. Of course, time may be the best option and this may mean waiting up to 2 years.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Fraxel restore Laser for Facial Scars

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HI Rhinolady,

A series of Fraxel restore laser treatments will greatly help. It may take a series of 4 to 6 treatments separated by 2 to 3 weeks for optimal results.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.