Solutions for indented alarplasty scarring? (Photo)

Question

I am about three weeks post-op from my septorhinoplasty, and I've noticed one of my nostril scars is healing differently than the other. It seems as though each side of the nostril rim opposite the incision is healing separately instead of blending together. The scar is quite indented/depressed. Can I expect this to get better with time, or perhaps with a silicone scar gel? Or should I expect a future scar revision to remedy this? Other than this minor issue, I'm very pleased with my results!

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

It's great to hear that you are pleased with your results overall. At three weeks post-op, it's still quite early in the healing process, and it's not uncommon for scars to appear indented or uneven as they heal. Scars can continue to mature and improve for up to a year after surgery.

Using silicone scar gel can be beneficial as it helps to hydrate the scar tissue and may improve its appearance over time. It's also important to follow your surgeon's post-operative care instructions and attend follow-up appointments to monitor the progress of your healing.

If the indentation does not improve significantly over the next several months, or if it becomes a cosmetic concern for you, a scar revision procedure could be considered. However, most surgeons would recommend waiting until the scar has fully matured before making any decisions about revision.

As always, discuss any concerns you have with your surgeon, as they can provide personalized advice and reassurance based on your specific situation.

Solutions for indented alarplasty scarring? (Photo)

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