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I had a primary rhinoplasty 2 years ago and a minor revision. I am somewhat confused by what scar tissue is though.

Your questions answered by our surgeon, Lucian Ion, FRCS(Plast)

Asked on 12 January 2014

Question

I had a primary rhinoplasty 2 years ago and after a fairly minor revision. I am somewhat confused by what scar tissue is though.

If I have some scar tissue still, is there an alternative to surgery to reduce this? How does excessive scar tissue form? Is it possible I still have some swelling left over from the original surgery?

Answer

In essence, we are used to seeing scar tissue develop in the skin wounds, but typically assume that on the inside the body somehow heals without producing the same type of scarring.

If you visualise the mechanism of rhinoplasty change, in order to access the support framework of the nose it is necessary to disconnect the soft tissues from it. This effectively creates a warned that covers approximately half the surface of the nose or sometimes even more, which during the healing period will produce a sheet of scar tissue of variable thickness.

The natural progression is for this scar tissue to build up and gradually to become thinner and softer.

If you are now two years following the original surgery, there is sufficient evidence to suggest that there is still some thicker scar tissue as it seems to take approximately 3 years for the nose to stop changing after the rhinoplasty although the majority of the changes would be during the first year.

In addition, one of the space that is poorly understood in the practice of rhinoplasty, is the surface reduction of the nose during a reduction rhinoplasty. Because there is no removal of skin during the surgery, when the nose becomes smaller there is some bunching up of the tissues which also creates the impression of swelling, and takes time to adapt, in particular in thicker nasal tip skin.

It is possible to reduce some of the scar tissue using steroid injections.

Lucian Ion Cosmetic Surgeon Mr Lucian Ion FRCS(Plast)
129 Harley Street
London
W1G 6BA

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