Horizontal scars left on the columella, the column between the nostrils, after rhinoplasty are a bothersome part every time you look in the mirror. Open rhinoplasty scars do not disappear naturally, but improvement is possible with treatment tailored to the scar's color and depth.
Why do columella scars form?
Open rhinoplasty involves horizontally incising the columella and then suturing it back. This leaves a horizontal mark on the column between the nostrils.
The nose is located at the center of the face and is a highly visible area, significantly impacting one's image. Many people undergo rhinoplasty for aesthetic improvement, and if an unexpected dark scar remains at the surgical site, it can cause significant stress.
Columella scars are mostly marks caused by open rhinoplasty in the middle of the nose. If you are planning nose surgery or are concerned about columella scars after rhinoplasty, the information today may be helpful.
The shape of remaining scars varies from person to person
Due to the nature of the surgery, incision and suturing of the nasal columella occur, leaving a horizontal, red, or depressed white scar on the columella, the column between the nostrils.
For those with good skin recovery, it may not be a significant problem. However, depending on skin characteristics, scars may remain noticeable, and especially for taller individuals, there are often many gazes looking up at the nose from below, leading to concerns that the scar in that area appears more prominent.
Columella scars are usually categorized into the following forms:
- Pigmented scars appearing red or brown
- Scars with black discoloration
- Depressed atrophic white scars
- Complex type with both color change at the top and depression at the bottom
Is ointment alone sufficient?
Applying ointment in the early stages can be somewhat helpful. However, the scar prevention effect of ointment is clearly limited, roughly 5-20%. Since columella scars do not disappear naturally, laser treatment is quite often performed in conjunction.
Once columella scars are established, they often do not fade on their own over time, so active treatment tailored to the color and depth can be helpful.
Not only nose scars but also other cosmetic surgery scars benefit from early management rather than neglect for better recovery.
For questions, inquire via chat consultation about nose scar treatment
Treatment approach tailored to scar color and depth
Unlike surgical scars in other areas, columella scars often have a depressed lower part, so laser and procedural methods may be combined for treatment. Since the approach varies depending on the scar condition, we first check both the color and the degree of depression during consultation.
| Scar Condition | Treatment Approach |
|---|---|
| Red or brown | Vascular laser to alleviate redness |
| Black discoloration | Laser toning type |
| White depression | Pinhole Technique to induce regeneration through micro-holes |
If the columella scar appears red or brown, vascular laser treatment to alleviate redness is performed. If it is discolored black, methods like laser toning can be helpful.
If the columella scar is depressed and white, performing Mild Pinhole, which uses a high-output laser to create micro-holes and induce skin regeneration, is effective.
Treatment timing to minimize scarring
To prevent scars, starting scar prevention laser treatment 1-2 weeks after suture removal is a good way to minimize scarring.
Here are some points to check for scar management after surgery:
- Check the scar condition around 1-2 weeks after suture removal.
- Record the scar's color and whether it is depressed.
- Reduce pigmentation by blocking UV rays.
- Consistently use ointment in the early stages, but be aware of its limitations.
- If changes are slow, consult with medical staff about the timing of laser treatment.
If you missed the timing
Using the Vbeam Prima laser, a vascular laser that alleviates redness in the early stages, can improve open rhinoplasty scars to some extent.
Occasionally, if the timing is missed, open rhinoplasty scars may remain as white, depressed scars. In such cases, consistent treatment using methods like the Ultrapulse Encore laser can lead to improvement. Surgical scars accompanied by depression, like columella scars, require an approach that addresses both color and depth.
Please note that treatment results may vary individually, so if you have scars due to nose surgery, do not worry and we recommend having your condition checked.
For questions, inquire via chat consultation about nose surgery scar treatment
Chief Director Lee Sang-joo (MD, PhD, Yonsei University College of Medicine and Graduate School, completed dermatology residency at Severance Hospital, President of the Korean Dermatological Association) Chief Director Lee Sang-joo's Profile First published 2024-10-11 / Last reviewed 2026-06-16
This article is for general information purposes only. The appearance of scars and treatment responses vary individually, so please consult with medical staff for an accurate diagnosis and treatment plan.