What treatment is suggested for a permanent Rhinoplasty scar after 4 years? (photos)

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

Your columellar scar requires scar revision since there is depression of tissue, non surgical treatments such as injectables or laser would not help your situation. Talk to your surgeon about your options.

You ask about non surgical options, laser can often improve scars, but your scar appears depressed & would best be addressed with a scar revision.  Speak with your surgeon about options.  Good Luck!

Bad columellar scar after open rhinoplasty can be excised and closed by your surgeon under local anesthesia. 

You have an inverted scar, meaning that the edges fold in and tend to create a noticeable scar due to shadows.  This can occur particularly in noses when goals of the surgery include reduction in the projection or outward size of the tip.  When this occurs, the patient simply has more skin than understructure.  We do not trim the skin in rhinoplasty as it almost always settles nicely to the new form without excess trauma involved from trimming. At times, this excess skin can fold in on itself before it has completely healed creating this scenario.I have seen this, albeit very rarely in my practice over 15 years but have found that simply numbing the area, and reapproximating this tissue in a slightly more supportive fashion (with vertical mattress sutures) should really help you out.Stay in close touch with your surgeon for best results in all cases.  You should have a great experience!Best regards,todd hobgood

I believe surgery is the way to go with your particular scars. The idea would be to excise the old scar and then to support the underlying cartilage such that when the new edges are brought together there is structural support to prevent them from inverting again.If you would rather try non surgical options first, then I think the fractional CO2 laser would be where to begin. It would help to blend the tissues. A vascular laser might also be necessary to minimize the redness. These can be done under topical or local anesthesia and should take minimal time to complete (5 minutes). You might need to have them repeated a few times before determining if the treatment is adequate to address your concerns.

Your columellar incision line is inverted as described by the other reviewers. To correct this does not require further support of your cartilaginous components, but will require a revision of your incision line but cutting out the inverted area and repairing it using a vertical mattress stitch that is intended to avoid inversion of the incision line.

Clearly the scar can be revised though obviousy one cannot guarantee the result particularly without an examination.  ask yourtreating surgeon his thoughts.Dr. Corbin

Your scar can be corrected non-surgically by CO2 Laser contouring along with a minimal amount of permanent filler injection to even out the scarred area.

Your scar can be revised with a minimal procedure under local anesthesia. I encourage you to have this done.