In general, how do revision rhinoplasty columella scars heal?

Question

Is there a greater risk the second time around cutting through the columella? And is the incision made in the same exact spot? I'm at 7 months post primary and my columella is still stiff, slightly numb and swollen looking. So I know I will need to wait at least a year. Thanks in advance!!

David C. Pearson, MD · Answer

Depending on where the original rhinoplasty scar was placed and how well it healed, the incision for the revision may use the original scar (re-closing it very precisely), may require a new incision (but again, properly done it should be nearly invisible), or may require excising the old scar entirely and creating a totally new and better one. Carefully done, all of these options can produce an excellent aesthetic result. Hope this helps,--DCPPearson Facial Plastic Surgery®

Juan Carlos Fuentes, MD · Answer

In average the scar in the columella, after a secondary or tertiary rhinoplasty, heal very well, if a good closure technique is used, and there is not too much tension on the scars. It is very important to wait one year for a secondary rhinoplasty, so the scar it is  soft and less chances of damaging the tissues during the dissection of that area,

Toby Mayer, MD · Answer

Revision rhinoplasty with excision of old  columellar scar?  this is done through the existing the score with removal of the old Scar at the same time.  As I described 40 years ago this scar is the easiest part of the operation, and if the surgeon cannot make the scar nearly invisible he should not be doing the nose.

William Portuese, MD · Answer

A revision rhinoplasty can be accomplished through a closed approach which completely prevents making an external incision. It's also best to wait at least a year to allow full healing to occur before embarking on another surgery

Robert S. Schmidt, MD · Answer

Thanks for your question. The columellar incision in a revision case generally goes exactly where the initial incision was placed. It heals great. For an example, with the columella well visualized, check out this example from my photo gallery. I did the incision slightly differently from what she had initially. Her scar from her first surgery is quite noticeable in her pre-op photo and looks virtually unchanged afterwards, meaning the scar I put there healed great.The stiffness and slight numbness that you're experiencing from your primary surgery is quite normal at this point, by the way. Nothing to worry about.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Columella incision is used for revision rhinoplasties and it heals well; could you provide a photo of your swollen columella and what it is that you  are tyring to achieve.

Richard W. Fleming, MD (retired) · Answer

If you're concerned about the columellar skin incision scar after an open rhinoplasty this can easily be revised under local anesthesia. If you're concerned about thickness in the tissue deep to the skin I suggest you talk to your surgeon but be patient because this may resolve over the next few months.

In general, how do revision rhinoplasty columella scars heal?

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