I have a depressed scar on my nose. What is the severity and what treatment options are there? (photos)

Hello from up North in Ottawa! I took a look at your photo and can certainly see the scar. Let me start by saying its always difficult to really give perfect advice on scar removal when seeing a photo, but at least I can give you some ideas of what is available. The first thing, we need to know why you have the scar and how deep it is. This helps determine how much of an improvement we may see with different treatments. If it is from surgery, sometimes you have what are called adhesions, basically little scars that 'pull' the skin. Once in a while we inject a medication that can help soften these, but that doesnt always work. From time to time, you need to cut the bands under the skin. If it is a scar from another reason, you could always consider injecting filler into it to flatten it out and blend it in. Sometimes this can work wonders. Another potential idea is laser treatment, both ablative and non-ablative. Ablative has longer downtown, but better results. Don't get me wrong, non-ablative lasers can do wonders as well and have little downtime and are less painfull and often less expensive. I think those are your best options, that is what I would typically discuss with patients at my Facial Plastic Surgery Clinic here in OttawaHope that is helpful,James P. Bonaparte, MD, MSc, FRCSCOtolaryngology - Head and Neck SurgeryFacial Plastic and Reconstructive Surgery Ottawa, Ontario, Canada

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

From the photo provided there appears to be a rather pronounced depressed, somewhat irregulary shaped nasal scar--made all the more visible by its position on the dorsum of the nasal tip. I have successfully improved scars like this in this anatomic location that have resulted from dog bite injuries and severe acne cysts using a combination of subcision and simultaneous or subsequent injection with a biostimulatory filler, such as Radiesse, combined with Perlane L. The entire process takes about ten to fifteen minutes to perform.Subcision breaks up the underlying scar tissue and promotes new, native collagen synthesis (neocollagenesis) over the next one to two months and the biostimulatory filler (which may be injected immediately following subcision or at a subsequent visit), as its name implies, not only fills and lifts the depression--to give immediate improvement--but further enhances new collagen synthesis. For more details on both these methods, you search the archives of Realself.com. Seeking consultation and treatment by a board certified aesthetic core physician with experience and expertise in scar treatment on the nose is a must.