Rhinoplasty changes the structure of your nose to correct deformities, alter the overall profile or to improve functionality. Plastic surgeons accomplish this by going inside your nose to shift segments around, add grafts and work with new support structures. As a result, surgeons notice a common theme with patients, such as worries about rhinoplasty scars from their procedure.

The truth is that you may have some scarring after your rhinoplasty, regardless if it’s an open or closed surgery, but it is often very minimal if the procedure is performed correctly.

Closed vs. Open Rhinoplasty

Closed Rhinoplasty

A closed (or endonasal) rhinoplasty does not make any incisions on the exterior of your nose. The surgeon works entirely through your nostrils, which results in no visible scarring. All of the alterations are made under the skin where scarring is only visible when the head is tilted back so the underside of your nose is exposed. The less severe incisions made during a closed rhinoplasty result in less swelling, quicker recovery time and less pain. Although open rhinoplasties are commonly preferred by many surgeons, experienced surgeons will offer the same results in a closed rhinoplasty depending on the situation.

Open Rhinoplasty

An open rhinoplasty (or the external approach) uses a small incision to open up the nose so the doctor gets a good look at your structure and the potential work that needs to be accomplished. The incision is made on the tissue between the nostrils on the underside of your nose called the columella. The skin is then lifted back for a more complex look at the bone and cartilage that is being modified. Again, this technique is more common amongst surgeons, but a skilled surgeon offers outstanding results with both techniques.

While closed rhinoplasty eliminates the chance of noticeable scars, this method doesn’t work for every patient. Relatively minor procedures fall under this area, while open rhinoplasty comes into play when you have extensive work involved in your nose job.

Scar Location

An open rhinoplasty cuts into a single location on the outside of your nose. The columella, part of your septum, is the area receiving the incision. This cut is typically shaped like an open-ended triangle. Since the scar develops on the underside of your nose, other people will have a hard time seeing it. The only angles where the scar will be visible is if someone is shorter than you or you have your head back. In normal day to day activity, it’s unlikely for most people to see it.

What Causes Scars to Get Worse

Several factors can make your rhinoplasty scar get worse:


If the incision site gets infected, your wound healing is interrupted. In some cases, the cut grows as the skin pulls away from this area. Your body’s energy moves away from healing the cut to trying to fight off the bacteria.

Sun Exposure

UV rays darken scar tissue and make it more noticeable than it would otherwise be. The pigmentation acts as a frame for the incision site and contrasts with the skin around it.


If you smoke, your blood has a lower oxygen concentration than a non-smoker. The body needs this oxygen supply to fuel the healing process, so smokers typically encounter slower rates with a higher risk of developing scars.

Damaged Skin

Your skin’s condition plays a part in whether you have clean healing or a lot of scar tissue. Dry and cracked skin makes it difficult for the body to heal your septum properly from the incision, while well-moisturized skin has less of a problem in this area.


Your body’s natural healing capabilities decrease as you get older, although everyone has their own pace for this process. You can’t heal a scar as well at 60 as you can at 20, so keep your age in mind when determining whether you’re going to end up with a visible scar.

Allergic Reaction

Allergies to anything used at the incision site or the postoperative supplies can cause irritation, rash or infection in the wound. If you don’t address this matter quickly, you could end up with a much larger scar.

What Does The Surgeon Do to Minimize Scarring?

In a traditional open (or external) rhinoplasty, surgeons are meticulous when making the incisions to reduce the chance of unnecessary scarring. The technique is referred to as a columellar incision (or a V-Plasty incision) and resembles an open triangle, ā€˜Vā€™ or a staircase. During the procedure, the surgeon is careful to not cause any extra irritation that will affect the healing process. Plastic surgeons (or any surgeons working with incisions) say that closing the incision is the most vital part of ensuring minimal scarring.

How Can You Minimize Rhinoplasty Scars?

Now that you know the factors involved in rhinoplasty scars after the proecdure, you should understand the steps you can take to reduce the chances of a noticeable scar.

Clean the Incision Site

Your plastic surgeon will give you full instructions on how to clean the incision site after you go home from the procedure. You need to follow these exactly to keep the area clear of bacteria, debris and anything else that could irritate the wound or stop it from healing.

Avoid Strenuous Activity for a Week

You don’t want to strain your nose or disturb the cast that’s in place as it heals. A few things you should avoid include blowing your nose, picking up heavy weights or doing anything that could result in nose trauma.

Stay Out of the Sun

The scar tissue may not fully fade for up to a year, depending on how your body handles scarring. During this time, sun exposure can cause the mark to darken. Use sunscreen in this area so you limit any damage.

Control Swelling

Your nose swells as part of the healing process after your surgery. Use ice packs and other methods to control the swelling so you don’t risk the incision pulling apart or damaging the healing process. Plus, you will feel more comfortable when you have a handle on this part of the rhinoplasty process.

Watch for Infections

Your incision site will look red immediately following your rhinoplasty, and some blood and drainage will occur. If the redness gets worse or you see pus, blood and other fluids coming out of the wound following this period, talk to your plastic surgeon. Another sign of infection is hot to the touch skin, or if you start running a fever without any mitigating circumstances. Infections cause major damage and may even be life-threatening, so get help right away.

You don’t have to worry about rhinoplasty scars in most cases, as much of the work is done inside the nostrils rather than on the outside of the nose. The appearance of rhinoplasty scars is discouraging. Having a plastic surgeon with proper training and plenty of experience will ensure that the worry of a scar will not overpower the excitement of your new nose.

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Dr. Winters

About Dr. Winters

Dr. Winters specializes in primary, revision, reconstructive, functional and teenage rhinoplasty surgeries. Dr. Winters is a fellow of the American College of Surgeons and maintains active memberships in the American Society of Plastic Surgeons, the American Society for Reconstructive Microsurgery and others.