what to do about columnellar scarring after rhinoplasty from another physician?

This is a question that i answered for a patient who had rhinoplasty done by another surgeon. She had some scarring under the nasal tip in the segment bewteen the nostrils from a worms eye view:

Having your surgeon use the best technique is vital to a great result and his skill will determine the amount of scarring that will take place after Rhinoplasty. Along your incisions, you should always have the them covered with vaseline and I would avoid antibacterial ointment to avoid contact dermatitis that is very common after surgery.

Hydrogen peroxide can be used judiciously and with the guidance of your physician, but when used without careful regard, this agent can increase scarring. Your incisions should look like a very fine wrinkle and this is the goal. When they are fairly clean I would avoid hydrogen peroxide and use vinegar and water in a 1 to 3 dilution or less, depending on your discomfort.

Keeping the crusting to a minimum will decrease the bacterial load and lead to less scarring. After the first 2 weeks, you can then use a silicone based scar gel to cover the incision for the next three months. External incisions are what you should use your silicone gel for and not the internal incisions inside your nostril. Minor scar treatments can lead to the best result; a resurfacing 4-8 weeks after your procedure can help!

Dr Young is located in Bellevue near Seattle, Washington

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