Should I Have External Scars from a Nose Job?

Dear Jay, NYNY
As a plastic surgeon I perform the rhinoplasty procedure either with internal (inside the nose only) incisions, or sometimes combined with skin, or external incisions. This distinction is otherwise known as either the "closed" or "open" technique. Much of this is determined on the difficulty of the procedure, and/or the training of the surgeon. When perorming an "open" approach the additional external incision is placed across the the mid point of the skin bridge between the nostrils (columella).
However, in some cases in addition to these two choices of incision technique the surgeon may also need to shape, or narrow, the width of the nostrils. This is commonly referred to as performing Alar, or Weir, Incisions. By your description it seems that this is what you are referring to.
I hope this helps clarify.
Best wishes,
S.P. Maggi, MD, FACS

Jay 1013, based on your description it appears that you had 'base incisions' used to narrow the width of the nose where it attaches to the cheek and upper lip. This is commonly done to address a flared nostril or a nose that is simply too wide at the base. If you don't see any sutures across the columella (the vertical column separating the left and right nostrils), you likely had a closed rhinoplasty approach.

An open rhinoplasty approach involves an incision across the columella, which would be easily seen at this point. With proper and careful technique the external incisions, including the base incisions you have, will usually heal with very little visibility of the scar. Good luck.

In general if you have had an open rhinoplasty, incisions are placed on the columella (the divider of your nostrils) and occasionally at the base of your nostrils (if your surgeon has narrowed the base of your nose).
I am unsure as to the significance of the circles you describe. It does not sound normal to me, but you will just have to see what happens when your bandages come off. More than likely it is a normal variant and you have nothing to fear.

Exernal scars would be visible and expected if the surgeon performed an open rhinoplasty. You should review the scope of the surgery with your surgery to understand fully what procedure was performed.

It depends on the type of rhinoplasty that you had and the actual parts of the operation which were performed. The two main types of rhinoplasty are open and closed. In a closed rhinoplasty, all incisions are made on the inside of the nose. Unfortunately this is not the best approach for some patients. In an open rhinoplasty, most incisions are on the inside of the nose except for one that goes across the columella, the bridge of skin that goes from the tip of your nose to your upper lip. When healed, this incision is generally not an issue. At times, additional incisions may need to be made on the side of the nose near the eyes to break the nose or along the alar rim, the out part of the nose that connects to the upper lip, to narrow the nose. In all, any of these incisions should heal without much of a problem.