Rhinoplasty scars #scarrevision
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!
Columellar incision inversion
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.
Columella scarring treatment options
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 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.
Open Rhinoplasty Scar
Your scar can be revised with a minimal procedure under local anesthesia. I encourage you to have this done.
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!
Clearly the scar can be revised though obviousy one cannot guarantee the result particularly without an examination. ask yourtreating surgeon his thoughts.
Bad columellar scar after open rhinoplasty.
Bad columellar scar after open rhinoplasty can be excised and closed by your surgeon under local anesthesia.