Methods for correcting keloid scars after rhinoplasty

Good afternoon, I'm worried about how my skin will look after the cast is removed. Tell me, is there anything I can do to keep my skin beautiful?

Proper skin care before and after rhinoplasty is very important. Why? The thing is that the skin is subjected to serious impact, both during the operation and after. Firstly, it is often treated with antiseptic solutions, and secondly, part of the face is under plaster for a long time without the possibility of cleansing it. As a result, problems may arise with the treatment of the skin.

Causes of keloid scars after rhinoplasty

Correcting the shape of the nose involves the process of dissecting tissues to further correct their location.

After the operation is completed, the incision site tends to bleed if poorly treated, which can subsequently cause scarring of the dermis. After a while, a scar forms at the site where the scar formed.

The very first reason for the formation of scars is an incorrectly selected surgeon with little experience or repeated unsuccessful practice in correcting the shape of the nose. You should be aware that only a highly qualified specialist can achieve the desired aesthetic result.

The next item on the list of reasons for the appearance of scars is ignoring medical advice during the rehabilitation period and skipping a scheduled examination.

The appearance of a scar after nose correction depends on the type of surgery. Rhinoplasty can be of open or closed type.

Open rhinoplasty is performed by making an external incision in the nose area. After completion of the surgical intervention, a thin scar forms, which dissolves after 1 year according to medical practice.

Open rhinoplasty

Closed rhinoplasty is performed by making an internal incision into the nasal tissue. The operation does not involve the formation of external sutures as such. With this type of nose correction, internal scars may appear that cause discomfort when breathing.

Closed rhinoplasty

Necrosis and infection of tissues, causing the formation of scars, appear gradually, after a long period of time. Negative consequences should be combated by introducing hormonal injections, laser restoration and mechanical cleansing of facial tissues.

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Phased changes

The rehabilitation period after rhinoplasty depends on the complexity of the operation. So, if the defect is small, the patient will receive minimal injuries. With a complex of corrections, the area of ​​soft tissue, bones and cartilage is affected. Therefore, recovery time increases and discomfort becomes stronger.

Rehabilitation is also influenced by the individual characteristics of the body, the method of implementation, materials, and compliance with the doctor’s recommendations.

How does the nose change after rhinoplasty, when is the result visible and what could be the consequences?

At the beginning

Medication-induced sleep is often used. So, immediately after the procedure the patient recovers from anesthesia. He feels nausea, drowsiness, weakness, dizziness. After the anesthetics are removed from the body, the condition improves. The sensations at this stage depend on the successful selection of the drug and dosage.

To reduce discomfort before plastic surgery, premedication is done - preparation with medications for surgery and anesthesia.
Without appropriate help, broken capillaries in the eyes, nosebleeds, and severe pain are possible .
The result of the operation cannot be seen immediately. After suturing, medical tampons - turundas - are inserted into the nose. They help reduce swelling by absorbing secretions. Modern materials that are similar to turundas are silicone splints or hemostatic collagen sponges. They allow you to breathe after surgery because they are installed with an air duct. Modern materials are easy to remove - they do not stick to the mucous membrane.

On top - fix an overlay made of plastic or plaster. However, plaster bandages are often abandoned, since if the swelling quickly disappears, the splint will have to be placed again . After a major operation, it is painful and traumatic. Plastic fasteners are more gentle. They will help protect the tissues formed by the surgeon from external influences.

You can learn more about the stages of rhinoplasty, how preparation, surgery and rehabilitation take place in our special material.

In the first days

In the first days after surgery, the patient is prescribed painkillers and antibiotics that will prevent fever and inflammation. The doctor selects medications individually, the form of administration is injections.

Due to swelling, the face looks frightening and the eyes appear swollen . Dark circles are visible around them. Possible visual impairment. The cheeks may also be swollen. The nose may become numb.

On day 3, vision returns to normal and the pain subsides. According to reviews, the first 2-3 days after surgery are the hardest.

To 10

• If turundas are installed in the nasal passages, they are removed on the fourth day. Because of the swelling, you won't be able to breathe yet.
• After 5-7 days, the amount of fluid in the tissues decreases, swelling gradually disappears, and the face becomes normal. With normal rehabilitation, the pain goes away.
• From the sixth to the eighth days, the splint is changed and the suture is removed (in an open operation). The hematomas gradually resolve and breathing is restored.
• After 10-14 days, the bandages and medical tampons are removed.

Up to two weeks

From the tenth to the fourteenth day, the clamps are finally removed . After this, they are allowed to go to work. The condition of the respiratory organ, both externally and internally, is not ideal. The swelling has not yet gone down, so it is too early to draw conclusions about the results.

Up to a month

After two or three weeks the patient gets used to the restrictions. From this date the next stage of recovery begins. Without stitches and a fixator, you feel better, despite difficulty breathing through your nose. The swelling and bruising have not yet gone completely. Within three weeks the swelling goes down by half. You can see the outline of the nose.

After 30 days

When do bruises go away? Externally, after a month, bruises, swelling, hematomas, and swelling disappear. The man looks great in the photo. There is still an effect from surgery - numbness of the nose and upper lip. The shape of the nose will still change, so the current result is not final .

After 60 and more

• In the second month, the doctor prescribes procedures for regeneration and elimination of minor cosmetic defects. During these two months, you must constantly visit the clinic and follow the instructions.
• By the third month the swelling goes away. The size and shape of the nose are determined by the surgeon. With a successful operation, the defects disappear. However, mistakes made during plastic surgery will become noticeable.

You can draw the first conclusions about the success of the operation and decide whether it is worth correcting the nasal defects further. During this period, the doctor allows you to return to an active lifestyle.

What do keloid scars look like?

Keloid scars are a rather unaesthetic result of rhinoplasty, causing a lot of inconvenience . They extend beyond the boundaries of the cut and tend to increase in size.

They are formed due to excessive growth of connective tissues at the site of violation of the integrity of the skin.

keloid scar photo
Keloids are characterized by a sharp visual highlight on the skin, a bluish or dark red tint.

The size and shape of scars depends on the formation of fibroblast, whose function is to regenerate old tissue and form new one.

Conservative correction of keloid scars

Keloid scars are removed both through surgery and therapeutic methods.

Conservative (therapeutic) correction is based on the transfer of the rough hypertrophic form of the scar to a normotrophic one, when the scars become visually invisible.

Use of corticosteroids

The essence of scar treatment is water hormonal agents (triamcinolone (Kenalog-40) and hydrocortisone acetate suspension) in the form of injections into the places where scars form.

Corticosteroid therapy prevents the formation of lumps. After 1.5 months, the patient’s skin becomes smooth. You can avoid relapse by regularly using corticosteroid medications.

Immunomodulatory therapy

Therapy is carried out by administering interferon alpha and interferon beta. It is prescribed to people whose scars have formed after undergoing surgery.

Immunomodulatory therapy reduces collagen fibers that contribute to tissue scarring. The first administration of immunomodulatory therapy drugs is carried out during the first surgical intervention.

Repeated administration is carried out after 14 days, and thereafter - every 7 days for 16 weeks.

Enzymes for breaking down hyaluronic acid

An enzyme that has the ability to break down hyaluronic acid is called hyaluronidase.

There are 3 types of it used in cosmetology.:

• Ronidase;
• lidase;
• longidaz.

But all of them are aimed at breaking down hyaluronic acid, which is the basis of the keloid scar.

Correction of keloid scars after rhinoplasty is carried out with testicular hyaluronidase. Depolymerization of the enzyme stops the formation of collagen and increases the permeability of skin tissue.

As a result of the action of the enzyme, the elasticity of the dermis increases, the contour of scars decreases, and they resolve.

This enzyme is introduced into the body to saturate it in the cells of the cytoplasm and intercellular matrix. When the enzyme is introduced, an optimal balance of hyaluronic acid is maintained in connective tissues.

To visualize the first results, one injection is enough, but to completely eliminate the scar it is necessary to undergo a course of enzyme injection procedures ranging from 8 to 25 visits.

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Revision rhinoplasty

Unsuccessful rhinoplasty often becomes the reason for returning to the doctor. However, the secondary procedure may be much more difficult and more expensive than the first. It often ends in complications and requires long-term rehabilitation. Sutures are removed only on days 7–8, and swelling and hematomas do not disappear for 2 months.

Repeated rhinoplasty is performed no earlier than a year after the primary, when the body is sufficiently strong and the nose takes its final shape.

Physiotherapeutic methods for correcting keloid scars

If you want to completely get rid of a keloid scar, the best option for solving this problem would be to remove it.

To do this, a cosmetologist can resort to microcurrents with medicinal ointments or laser therapy.

Microcurrent with healing ointments or gels

The procedure for correcting keloid scars after rhinoplasty takes place in 3 stages:

1. Individual selection of cosmetics depending on the condition and type of skin.
2. Applying a thin layer of ointment or gel for the procedure (application of Contractubex, Mederma, Kelofibraz, Fermenkol, Zaderma or other cosmetic substance as prescribed by a cosmetologist).
3. Exposure of the skin to electrical impulses. The pulsation frequency is adjusted by the cosmetologist depending on the size of the scar.

After the procedure, a large number of intracellular processes are activated. Accelerated cell regeneration improves the structure of the skin, giving it smoothness and elasticity.

It is worth noting that the procedure is contraindicated for persons:

• with purulent pathologies;
• with cancer;
• with epilepsy;
• whose internal organs have severe pathology.

To completely remove a keloid scar, a course of 10 to 15 procedures will be required.

Cost from 1000 to 3000 rubles. for 1 procedure.

Photos before and after rhinoplasty

Laser therapy for scars

After rhinoplasty, keloid scars can be corrected using laser therapy.

Laser therapy for scars is possible in two ways:

1. Ablative , during which rough tissue is removed by evaporation. The most effective way to combat scars, however, it has a long rehabilitation period. Complete removal of scars occurs after 6 procedures.
2. Non-ablative , triggering the regeneration of deep skin epithelium. A more gentle, but less effective option for the skin. Complete removal of scars occurs after 12 procedures.

Ablative laser correction, in turn, is carried out both carbon dioxide (recommended for people with oily skin due to the fact that CO2 has a narrowing effect on the pores) and erbium (gentle, suitable for dry skin types).

People with epilepsy, psoriasis, dermatitis, low blood clotting, and pregnant and nursing mothers should not resort to correction of keloid scars after unsuccessful rhinoplasty.

The cost of the procedure is from 1500 to 8000 rubles.

Photos before and after rhinoplasty

Possible complications and consequences

The most common complication after the procedure is patient dissatisfaction. The nose may not turn out as expected, or the new shape of the ideal nose may not match other proportions of other parts of the face. In addition, curvature and asymmetry may appear.

During the postoperative period, all patients experience swelling and circles under the eyes; this is considered a normal reaction of the body to the procedure. During the first two weeks, redness, bruising, and difficulty breathing may also be observed.

More serious medical consequences include 2 large groups: functional and aesthetic disorders.

The first group includes:

• The appearance of inflammation, suppuration, or abscess.
• Allergic reactions, even shock.
• Damage to the septum and breathing problems.
• Callus formation.
• Atrophic rhinitis.
• Complications after the effects of anesthesia.

Aesthetic motives can fail if:

• Saddle-shaped organ or curvature.
• A drooping or excessively upturned tip of the nose.
• Adhesions, scars, seam divergence.

Correction of keloids using cosmetic procedures

Poorly performed rhinoplasty leads to the need for correction of keloid scars. After 6 months, it is recommended to resort to cosmetic procedures.

Peeling procedures

When removing scars with peeling, the top layer of rough skin and scarred tissue are destroyed. The procedure is carried out with a retinoic, phenolic composition or trichloroacetic acid.

Both physical and mechanical peeling are based on the following processes:

• The rough fabric is dissolved using acid and then sanded with fine abrasive.
• During the peeling session, the metabolic processes of healthy cells are activated and the formation of collagen fibers is normalized.
• Peeling of scars occurs together with the top layer of the skin.
• After 10 days, new smooth skin is formed.

The peeling procedure is contraindicated during pregnancy and breastfeeding, individual intolerance to the peeling composition, cancer, kidney and liver failure, heart disease, rosacea, high blood pressure, diabetes.

The cost of the procedure is from 5,000 to 25,000 rubles.

Deep dermabrasion

With old or large scars, peeling may not cope with the task of removing them. In such cases, cosmetologists recommend resorting to skin dermabrasion.

Deep dermabrasion is used to remove very noticeable scars. When the damaged tissue rises significantly above the surface of the face. Resurfacing occurs in stages, removing the rough layers of skin one by one. As a result, this leads to comparison of the skin and equalization of the color of the epithelium.

Dermabrasion should have a course approach, but the number of operations should not exceed 3 operations with an interval of 10 days. It should be noted that this method of scar removal is quite painful and is carried out under the influence of anesthesia.

The cost of the procedure is from 2000 to 8000 rubles.

Mesotherapy

Scars that are small in depth and size are recommended to be removed using mesotherapy.

When the drug is injected, regeneration of the dermis is initiated, cellular metabolism is activated and the scar is smoothed.

It is very important to choose a highly qualified specialist both to prescribe injections and to administer them.

To remove scars, injections such as Restylane Vital (USA), Placentex Integro (Italy), IAL System (Spain), Revofil Aqua (Seoul) are used.

The procedure can be carried out manually and using hardware. It should be noted that manual injection input is more accurate than hardware input.

The standard course duration is 10 procedures, but this figure can change either up or down on the recommendation of a cosmetologist.

The cost of the procedure is from 3,000 to 12,000 rubles. depending on the injection manufacturer.

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Surgical correction of keloid scars

One of the fastest and most effective ways to remove scars is surgical correction.

The procedure for excision of postoperative scars is carried out only after the complete formation of the scar, at least 3 months after its formation.

When the scar connective tissue is removed, the surgeon applies an intradermal cosmetic suture.

The process of surgical removal of keloid scars is carried out under both general and local anesthesia. The duration of the recovery period after surgery is 3 weeks.

The cost of the procedure is from 6,000 to 35,000 rubles.

Correction of keloid scars after rhinoplasty is a rather complicated procedure. But if you contact a highly qualified specialist in a timely manner, the result will please you for many years.