Understanding External Rhinoplasty Scars

When considering rhinoplasty, many patients are curious about where the incisions will be placed and how they will heal. There are two primary types of external incisions used to achieve a balanced, beautiful result:

• The Columellar Incision (Open Approach): This incision is placed on the columella, which is the fleshy strip of tissue between your nostrils. Because the skin quality in this area is exceptional, the incision typically heals into a very fine, faint line that is rarely noticed by others once fully matured. While patients often worry about visibility, significant scarring in this area is rare, occurring in 1% of cases.

• The Alar Base Incision: If we are narrowing the base of the nose or adjusting the nostrils, an incision is placed discreetly within the natural creases where the nose meets the cheek. The skin here is slightly thicker and contains more oil glands than the columella, which can occasionally result in a more pronounced scar; however, its placement within the natural anatomy helps keep it well-hidden.

Below is an example of a typical columellar and alar base scar and also examples of poor scaring Dr Oakley has seen over the years.