What procedure would be best to treat this nose scar? (Photos)

Question

I have a scar on my nose and i’ve consulted a doctor who mentioned skin flap surgery to remove the scar. Why would this be better than just cutting out the scar surgically? And wouldn’t it be safer since it’s done with local anesthesia? The scar could also be reduced with lasers. I would appreciate advice on this, thank you

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

From what I can see, the elevated there appears to be an elevated, likely a hypertrophic component to the scar, particularly in the center photo. If this is so, then an intralesional injection of an anti-inflammatory agent to flatten it would be in order.  There appears also to be a horizontal depressed & hypopigmented component running horizontally across the bridge of the nose. If this is indeed so, then subcision can be used to elevate and smooth it, which can then be followed by Dermastamp microneedling accompanied by the application of topical prescription pigment promoters, such as tyrosine and lanatoprost to help to better blend the surface color and texture of the scar with the surrounding normal skin. And all of this without cutting, stitching, grafts, and expensive (but largely unproven) lasers. Make sure to consult with an experienced board certified cosmetic dermatologist. Hope this helps.

What procedure would be best to treat this nose scar? (Photos)

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What procedure would be best to treat this nose scar? (Photos)

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