Columellar incision forming scar tissue bump after open rhinoplasty. Any suggestions?

Question

I am currently 4 weeks post open rhino. My nose is still very swollen and the most swelling seems to be in my nostrils, tip and colemellar section. As the incision scars heal ive notice a hard white bump forming on the columellar scar. No pain or drainage just unsightly. I brought my concern to my plastic surgeon and he said to wait it out another month but that he has never had such a case. I am using bio oil scar treatment currently, other creams/oils i should be using? is this common?

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

Christian L. Stallworth, MD · Answer

Columellar incisions traditionally heal very well. This, though, is dependent on proper placement, execution, and closure. You are still very early in healing and it is not uncommon to have residual swelling and tenderness in this area. Without pictures and an exam, it is hard to say for sure what is going on. This could be scar, a misplaced or migrated graft, infection, or possibly a retained/dissolving or spitting stitch. It is also possible to get a small epidermal inclusion cyst from a clogged gland or trapped debris In the suture tract. Only your surgeon can say for sure at this point. Playing the odds, I would stick with you surgeon and wait it out. Keep your follow ups and make sure your concern is addressed. More than likely this will heal just fine.

Steven Wallach, MD · Answer

It is fairly common for the scar to get  a bit swollen. Sometimes milia develop at the incision site. Best to be seen in person.

Mark Loury, MD, FACS (retired) · Answer

At this time scars are most firm. They can soften with massage. The white spot could be scar, a small inclusion cyst, superficial subcutaneous suture material, or a piece of cartilage. The tip area is the most swollen and takes the longest to subside. Please keep your follow up. It will be more apparent then what exactly is happening

Columellar incision forming scar tissue bump after open rhinoplasty. Any suggestions?

Answers (4)

Answer: Collumellar scar

Answer: Collumellar scar

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Columellar incision forming scar tissue bump after open rhinoplasty. Any suggestions?

Answers (4)

Answer: Collumellar scar

Answer: Collumellar scar

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