Scars should not be an issue after rhinoplasty
In closed, or endonasal, rhinoplasty all the incisions are typically made inside the nostrils. No external incisions are made whatsoever, with the uncommon exception of surgeries which include nostril-narrowing procedures such as the Weir excision or sill excision.
In open rhinoplasty, a tiny incision is made across the columella, typically in the shape of an upside-down "V" or a stairstep. If this incision is created and repaired carefully, the resultant scar should be nearly invisible. The small incision is a worthwhile tradeoff if your surgeon feels that she or he can have a greater chance of success in achieving your aesthetic and functional goals through an open approach.
Overall, scarring should not be a concern in rhinoplasty if you undergo surgery with a specialist in this area.
Rhinoplasty can be done with no visible scars by placing all incisions inside the nose.
This is called "Closed" Rhinoplasty.
Ask your surgeon if you are a good candidate.
Visible Scars After A Rhinoplasty
Anytime a scar is created, it will leave a mark. An experienced and well trained rhinoplasty surgeon will do a variety of maneuvers to make the scar less visible.
Typically, in an open rhinoplasty, there is an incision between the nostrils in the columella. Scarring around the nostril area (termed the alar base) can also leave scars which can become visible. This incision will usually heal well depending on a variety of factors including:
Surgeon technical competence
Design and location of scar
Type of suture used
When suture is removed
I see a large percentage of revision rhinoplasty patients (from outside surgeons) and notice a wide gamut in scar quality and formation. Meticulous closure of scars will make scars difficult to see with rhinoplasty.
There are two types of rhinoplasties: open and closed. In an open approach, there is small incision made on the columella, which is the part of the nose between the nostrils. This heals very well and is virtually undetectable in most cases. A closed rhinoplasty involves no external incisions, with all the incisions located inside the nostrils. The open approach allows for better exposure especially if more intricate work is to be done on the nasal tip or a paient requires a revision.
Please ask your surgeon to see photos of this incision and to discuss the options available to you for rhinoplasty techniques.
Scars are scars and are premanent....That having been said, in the hands of an experienced rhinoplasty surgeon, whether OPEN or CLOSED, these scars should melt away and be virtually impossible to detect.
This is a great operation for the right patient in the right hands....search carefully, solicit many professional opinions and I am sure you will be very happy!
Most rhinoplasties (nose jobs) can be done with either no incision or a very small incision
There are two ways to approach the nose when performing a rhinoplasty (nose job). The first is the closed rhinoplasty. In this surgery, the surgeon approaches the anatomy through the inside of the nostrils. There are incisions, but they are all inside of your nose (kind of like doing the surgery from the inside-out). This apprach is best for straight-forward noses which do not need extensive work. The other approach is called the open rhinoplasty. In this apporach, a small incision in made in your columella (the strip of skin betwen your nostrils) and then the skin of your nose is retracted to expose the bones and cartilage. This approach is useful for complex noses. However, some surgeons do all of their surgerys through the open apporach and there is nothing wrong with that. For the most part, these incisions heal very well, so I would not be worried about whether your surgeon uses an open or a closed approach.
I hope this is helpful.
Dr. David Shafer, www.DoctorShafer.com
New York City
Visible Scars from a Nose Job
If you are a candidate, a closed rhinoplasty can be performed where the incisions are inside the nose. In this case, there would not be any visible scars. Consult with 3 - 4 board certified plastic surgeons to explore your options.
Rhinoplasty Is A Scarless Procedure
`For the most part, rhinoplasty does not involve any visible scars and that concern is not usually an important one. It is true that in an open rhinoplasty an incision is used across the strip of skin between the nostrils. (columella) But incision almost always heals so well that a resulting visible scar or the need for scar revision of it is very uncommon.
Rhinoplasty Incisions Usually Hidden Inside the Nose
There are basically two approaches to accessing the nasal structures when performing a rhinoplasty. One is called "closed" and the other "open". Truth is, they are both open, the question is where the opening is made. In a "closed" approach, all of the incisions are inside of the nose leaving the patient with no visible scars. In contrast, the "open" approach includes an incision across the skin between the nostrils (columella). While this incision is small and heals well, I still avoid it in more than 90% of my rhinoplasty surgery. Noses that will require grafts to the nasal tip are typically the only ones where I make this incision. I don't need this incision during rhinoplasty if the goal is a smaller nose, which happens to be the goal for most people.
Rhinoplasty can be performed by the 'closed' technique, in which all incisions are placed within the nostril, or the 'open' approach, in which an incision is also placed on the columella, the skin between the nostrils. This incision is external but heals extremely well and is almost imperceptible. Occasionally, osteotomies to cut the bones and narrow the nose are performed through external incisions on the side of the nose. These are 2 mm and also heal extremely well.
All the best,
Jeff Weinzweig, MD