Nose Indented From Scar Revision - How Can I Fix This? (Photos)

Question

What procedure would typically be recommended to address a nasal contour indentation left after a scar revision? Its seriorusly bothering me and affected my social life/self confidence. I’ve had one subcision session so far. Should I continue with additional subcision, or should I be considering options such as PRP, filler, fat grafting, or another procedure? I'd really appreciate any advice or shared experiences. Thank you.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a rhinoplasty to help improve your tip and supratip contour. A fascial graft could be used to improve the indentation. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Mert Demirel, MD · Answer

A nasal contour indentation after scar revision is usually caused by tethering of the skin to deeper scar tissue, loss of soft tissue volume, or an uneven healing plane under the skin. In some cases, it is a true depression from tissue deficiency; in others, the scar is pulling the skin inward.
Subcision can help if the main problem is tethering, but one session is not always enough. That said, repeated subcision should be done carefully on the nose because the skin is thin, the blood supply is important, and over-aggressive treatment can create more irregularity.
If there is volume loss after the tethering is released, the area may need support. Small amounts of filler can be useful as a temporary and conservative test, but it must be done by someone very experienced with nasal injections because the nose is a high-risk area for vascular complications. Fat grafting or a tiny soft tissue graft can be considered for a more permanent correction, but results can be less predictable in such a small area.
PRP may improve skin quality, but it usually does not correct a true indentation by itself. If the depression is significant, PRP alone is unlikely to be enough.
My advice would be to have the area assessed by a revision rhinoplasty surgeon or a dermatologist/plastic surgeon experienced in scar revision. The best plan may be staged: first release the tethering if present, then cautiously restore volume if needed. I would avoid rushing into multiple treatments without a clear diagnosis of whether the problem is tethering, volume loss, or both.

Zoran Potparic, MD · Answer

Fillers and fat grafts may be an option to start with but I believe that long lasting correction will need an open surgical correction with placement of cartilage graft(s). Hope this helps.

Nose Indented From Scar Revision - How Can I Fix This? (Photos)

Answers (3)

More Rhinoplasty Questions

How can I make my subnasale rounder? (Photo)

Can a rhinoplasty scar reopen 7 years post op? (Photos)

Is it better to do rhinoplasty and lip lift at the same time?

Two years post rhinoplasty - How can I treat this bump? (Photo)

What are the usual parameters for a diabetic considering rhinoplasty ?

Nose cartilage moving to the right side - how can I fix this? (Photos)

WE SEND PRETTY
EMAILS