Open rhinoplasty scar may be observed over the mid columella of the nose. The columella of the nose is described by the skin and soft tissue located at the central bottom of the nose and separates the opening of the two nostrils. When performing open rhinoplasty, an incision is extended from one nostril to the other across the mid columella level. If the columellar incisions are not repaired appropriately, then an open rhinoplasty scar may become evident. First of all, this incision must be repaired in layered fashion and not with a simple external stitch repair.
The use of an internal stitch using a reabsorbably suture allows for the incision line to continue having support despite removal of the external stitch after one week. The internal suture that we utilize provides support of the incision for up to 3 months thus allowing the incision to heal optimally. The second important consideration is that the upper incision flap must be directed centrally in comparison to the lower incision flap in order to allow for optimal columellar alignment.
This is because the upper nasal skin flap tends to pull up and laterally due to the tensions created following rhinoplasty. If this maneuver is not done, then the nasal incision will create unnecessary contour deformities resulting in a more prominent scar.
When viewing open rhinoplasty before and after photos, please note the avoidance of an open rhinoplasty scar. Open rhinoplasty success is achieved by not only optimizing nasal contour but avoiding an open rhinoplasty scar.
Please see this 35 female who demonstrates improvement in tip highlights, improved nasal dorsal harmony, and avoidance of an open rhinoplasty scar.