Rhinoplasty is one of the most popular plastic surgery requests among patients worldwide, but around 10% of patients choose to get another one once they’ve recovered. This is usually for one of two reasons: the original nose job needs a touch-up to improve the primary procedure, or the primary procedure was done poorly and the nose needs drastic improvement.
Revision rhinoplasty can help dissatisfied rhinoplasty patients get the nose they truly want, but not without some obstacles. One of those obstacles is the formation of scar tissue, which can make a revision procedure more challenging.
How Does Scar Tissue Form?
When your body suffers an injury that tears, cuts, or rips the skin, fibroblast cells are deployed to begin making repairs. These cells start pulling together collagen fibers and other proteins to knit the skin back together.
While your skin is healing, it has a reddened appearance and is noticeably thicker than the surrounding tissue. Once it completely recovers from the injury, scar tissue starts to look whiter in color.
The way that scar tissue forms varies among individuals. Some people develop scar tissue that is really thick and noticeable; others have scars that are thinner and blend in better with the surrounding skin. It isn’t really clear what causes scars to vary so much, but there are several factors that can influence the formation of scar tissue, including age, skin elasticity, genetics, skin pigmentation, and the injury itself.
Is Scar Tissue After Rhinoplasty Common?
Scarring is expected after rhinoplasty. Depending on the individual, some people may notice more scarring than others. While excessive scarring can happen, a trained surgeon will help patients achieve a natural look.
An open rhinoplasty procedure involves one incision on the outside of the nose. When part of the septum is cut into a triangular shape, the scar will develop along the inside of the nose. Once the procedure is over, scar tissue must form to ensure the wound has properly healed.
What Does Excessive Scar Tissue Look Like?
Excessive scar tissue occurs when there are multiple layers of scarring present. This typically appears raised with a reddish hue. The area often has a hardened texture and can feel rubbery. Although most scars fade with time, excessive scar tissue from rhinoplasty surgery may be uncomfortable.
While scar tissue will usually soften over the course of a few months, sometimes this process can take up to a year. During this time patients may notice a physical change in the shape of their nose.
One of the most noticeable areas of change occurs just above the tip of the nose. In some cases, certain medications may be able to help modify the appearance, but not all of them work for every patient. Abnormal scars that form between the nostrils may require correction with an experienced surgeon.
Why Does Scar Tissue Affect Revision Rhinoplasty?
Scar tissue forms to help strengthen and heal your skin after it is injured. It has to be tougher and thicker than your normal skin tissue to prevent the injury from getting infected or opening up again.
In a small area like the inside of your nose, tough and thick skin can make it difficult for the rhinoplasty surgeon to manipulate or shape the skin so that your nose looks aesthetically appealing. Scar tissue can also buckle or change its shape over time, something that needs to be considered by the surgeon in order to give you the best results possible.
Revision rhinoplasty can still be an effective procedure, even when the patient has excessive amounts of scar tissue from previous surgery or injury; the tissue just requires a skilled plastic surgeon that has the knowledge and ability to work around that obstacle.
How To Prevent Scar Tissue After Rhinoplasty
Without the right amount of scar tissue, a wound may be susceptible to future infection and heightened sensitivity. By covering the bone and cartilage inside the nose, scar tissue helps protect injured skin over the course of several weeks or months.
When there is too much scar tissue, however, it can continue to form inside the nose long after its initial purpose has been served. This causes the results of a rhinoplasty procedure to look and feel different than the expected outcome.
Excessive scarring can also prevent the nose from appearing fully natural without a second surgery. For this reason, many patients take special precautions to reduce the risk of noticeable scar tissue from appearing in the first place.
Lifestyle choices can play a significant role in the outcome of rhinoplasty. While excessive scar tissue can be caused by genetics, there are individual decisions that can also impact the formation of scars.
Smoking cigarettes is a leading risk factor for skin conditions of all types. According to one study from The Wound, Ostomy, and Continence Nurses Society, nicotine can affect the quality of wound healing over time. This may indicate potential healing issues from other forms of nicotine besides just cigarettes.
High blood pressure can also increase the risk of developing excess scar tissue. Maintaining a healthy blood pressure is often overlooked by younger adults, but can have an impact on the outcome of rhinoplasty surgery. By eating a healthy diet and exercising regularly, tissue buildup can be reduced.
Post-Surgical Care to Reduce Scarring
Although there are ways to prevent the likelihood of excess scarring before surgery, post-surgery instructions can also help. A skilled physician will provide specific directions to the patient for safe healing once they are home.
Is There Any Way I Can Minimize the Effect of My Scar Tissue?
The best way you can minimize the effect of your scar tissue is to take very good care of your skin. When your skin is healthy, it is much easier for the surgeon to work with and makes your recovery from revision rhinoplasty easier. Rhinoplasty scars are usually found inside your nose, but they will still reap the benefits of excellent skin care.
Another way to keep your scars from affecting your revision rhinoplasty is to allow plenty of time between the procedures. Scar tissue softens over time, which makes it easier to manipulate during surgery.
Choosing a Revision Rhinoplasty Surgeon
Scar tissue is only one of the challenges faced by plastic surgeons during revision rhinoplasty, so it’s very important that you choose a surgeon who knows what they’re doing. Choosing a surgeon who is board-certified and specializes in revision rhinoplasty, with a great deal of experience in both primary and revision rhinoplasty, will be your best option.
Dr. Andres Bustillo is a board-certified facial and reconstructive plastic surgeon who has been practicing cosmetic surgery for over ten years. Nasal surgeries, such as rhinoplasty and revision rhinoplasty, make up the majority of his practice.
Dr. Bustillo sees rhinoplasty and revision rhinoplasty patients from all over the world and is known as one of the best facial plastic surgeons in Florida. His conservative approach allows him to give his patients a quality experience and amazing, natural-looking results without overdoing the surgery.
If you are interested in scheduling a revision rhinoplasty patient consultation with Dr. Bustillo, call his office in Coral Gables, FL at (305) 663-3380 or send an email through his Contact page.