Rhinoplasty changes the structure of your nose to correct deformities, alter the overall profile or to improve functionality. Plastic surgeons accomplish this by going inside your nose to shift things around, add grafts and work with new support structures.

Having practiced plastic surgery here in New Jersey for decades, I’ve had countless patients come to me with worries about rhinoplasty scars from their procedure. The truth is that you may have some scarring after your rhinoplasty, regardless if it’s an open or closed surgery, but it is often very minimal if the procedure is performed correctly.

What are Closed and Open Rhinoplasty

A closed rhinoplasty does not make any incisions on the exterior of your nose. The surgeon works entirely through your nostrils, which results in no visible scarring. An open rhinoplasty uses a small incision to open up the nose, so the doctor gets a good look at your structure and the potential work that needs to be accomplished.

While closed rhinoplasty eliminates the chance of noticeable scars, this method doesn’t work for every patient. Relatively minor procedures fall under this area, while open rhinoplasty comes into play when you have extensive work involved in your nose job.

Scar Location

An open rhinoplasty cuts into a single location on the outside of your nose. The columella, part of your septum, is the area receiving the incision. This cut is typically shaped like an open-ended triangle. Since the scar develops on the underside of your nose, other people will have a hard time seeing it. The only angles where the scar will be visible is if someone is shorter than you or you have your head back. In normal day to day activity, it’s unlikely for most people to see it.

What Causes Scars to Get Worse

Several factors can make your rhinoplasty scar get worse:

Infection

If the incision site gets infected, your wound healing is interrupted. In some cases, the cut grows as the skin pulls away from this area. Your body’s energy moves away from healing the cut to trying to fight off the bacteria.

Sun Exposure

UV rays darken scar tissue and make it more noticeable than it would otherwise be. The pigmentation acts as a frame for the incision site and contrasts with the skin around it.

Smoking

If you smoke, your blood has a lower oxygen concentration than a non-smoker. The body needs this oxygen supply to fuel the healing process, so smokers typically encounter slower rates with a higher risk of developing scars.

Damaged Skin

Your skin’s condition plays a part in whether you have clean healing or a lot of scar tissue. Dry and cracked skin makes it difficult for the body to heal your septum properly from the incision, while well-moisturized skin has less of a problem in this area.

Age

Your body’s natural healing capabilities decrease as you get older, although everyone has their own pace for this process. You can’t heal a scar as well at 60 as you can at 20, so keep your age in mind when determining whether you’re going to end up with a visible scar.

Allergic Reaction

Allergies to anything used at the incision site or the postoperative supplies can cause irritation, rash or infection in the wound. If you don’t address this matter quickly, you could end up with a much larger scar.

How Can You Minimize Rhinoplasty Scars?

Now that you know the factors involved in scarring after a rhinoplasty, you should understand the steps you can take to reduce the chances of a noticeable scar.

Clean the Incision Site

Your plastic surgeon will give you full instructions on how to clean the incision site after you go home from the procedure. You need to follow these exactly to keep the area clear of bacteria, debris and anything else that could irritate the wound or stop it from healing.

Avoid Strenuous Activity for a Week

You don’t want to strain your nose or disturb the cast that’s in place as it heals. A few things you should avoid include blowing your nose, picking up heavy weights or doing anything that could result in nose trauma.

Stay Out of the Sun

The scar tissue may not fully fade for up to a year, depending on how your body handles scarring. During this time, sun exposure can cause the mark to darken. Use sunscreen in this area so you limit any damage.

Control Swelling

Your nose swells as part of the healing process after your surgery. Use ice packs and other methods to control the swelling so you don’t risk the incision pulling apart or damaging the healing process. Plus, you will feel more comfortable when you have a handle on this part of the rhinoplasty process.

Watch for Infections

Your incision site will look red immediately following your rhinoplasty, and some blood and drainage will occur. If the redness gets worse or you see pus, blood and other fluids coming out of the wound following this period, talk to your plastic surgeon. Another sign of infection is hot to the touch skin, or if you start running a fever without any mitigating circumstances. Infections cause major damage and may even be life-threatening, so get help right away.

You don’t have to worry about rhinoplasty scars in most cases, as much of the work is done inside the nostrils rather than on the outside of the nose. If you’re worried about your open rhinoplasty scar, these tips will help you minimize its appearance.

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About Dr. Winters

Dr. Winters specializes in primary, revision, reconstructive, functional and teenage rhinoplasty surgeries. Dr. Winters is a fellow of the American College of Surgeons and maintains active memberships in the American Society of Plastic Surgeons, the American Society for Reconstructive Microsurgery and others.