Will eversion help the outcome of re-excision of a sunken / atrophic / depressed scar on upper nose? (Photo)

Question

Complication from a Revision Rhinoplasty resulted in atrophic scar on bridge / upper dorsal area. Nine months ago, the surgeon excised the scar—originally improving it. However, since then, the scar widened and atrophied, resulting in the recurrence of a noticeable contour irregularity. Leaning towards re-excision with an emphasis on eversion of the edges. Thoughts?

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Laura A. Katz, MD · Answer

The morpheus8 radiofrequency microneedling device would likely work very well on this scar.  The radiofrequency energy is passed into the tissue anywhere from 1 to 4mm at preset distance setting,  The energy causes collagen production, skin plumping, muscle contraction and skin tightening, with significant results in as soon as one month.  Markings from the treatment are usually resolved within 24 to 48 hours.  Here is a helpful link about morpheus.

Will eversion help the outcome of re-excision of a sunken / atrophic / depressed scar on upper nose? (Photo)

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Everything you need to know about Scar Removal

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Will eversion help the outcome of re-excision of a sunken / atrophic / depressed scar on upper nose? (Photo)

Answers (2)

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Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.