Inverted v shaped dent in columella.

Question

I am looking to get my scar revised as there is an inverted v shape dent at the collumela incision site amd is very noticeable in profile. What can be done to correct this and will it affect the position of the tip. I definitely do not want to use fillers and am looking for a permanent fix Thanks in advance

Thomas A. Lamperti, MD · Answer

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.

John Michael Thomassen, MD · Answer

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.

Fred J. Bressler, MD, FACS · Answer

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.

William Portuese, MD · Answer

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

Victor Chung, MD · Answer

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.

Inverted v shaped dent in columella.

Answers (5)

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