Inverted v shaped dent in columella.
Doctor Answers 5
Columellar scar revision
It's very hard to say what your scar revision options are without seeing your scar. It may be possible to place a plumping graft in the area to help fill the depressed area in.
Rarely this scar needs to be revised. It can be done in the office setting simply by excising the scar and using fine sutures to repair it. This should not affect your tip position.
Columellar Incision Concerns
I am sorry that your columellar incision from your open rhinoplasty did not heal as expected. A simple scar revision with meticulous repair is offered for these types of cases and should not affect your tip position. Once everything heals, the improvement should be permanent. Best Wishes.
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Inverted V shaped dent in the columella from open rhinoplasty
Unfortunately, we have seen this issue all too often with open rhinoplasty. A closed approach accomplishes making all of the incisions on the inside of the nose to avoid this issue. A surgical scar revision may be helpful. In addition, if there is a hanging columella, this can be reduced with the columella-plasty which will better hide the scar. For more information and many before-and-after rhinoplasty examples, please see the video and the link below
Rhinoplasty: revising a columellar scar
For external (open) approach to rhinoplasty, a cut needs to made across the band of skin between your nostrils (columella). This incision needs to be designed and cut very precisely. It also needs to be closed very meticulously to decrease the visibility of the scar.
Visible scars may be revised by cutting out the old scar and closing it very carefully. This requires adequate skin and midcolumellar position. If there is too much tension or it is too close to the base of the nose or apex of the nostrils, revision may not be possible. Skin resurfacing (dermabrasion) may potentially improve unsightly scars.