Treatment for external rhinoplasty scars
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.
Fraxel restore Laser for Facial Scars
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.
Scars respond to injections and laser
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.
Treating external Rhinoplasty scars
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.
Correcting External Nose Scar
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.
Treatment for nasal scar.
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.
External rhinoplasty scar
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
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.