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If you are thinking about rhinoplasty or are in the early stages of healing, it is completely normal to worry about scar tissue. The good news is that most rhinoplasty scars are either hidden inside the nostrils or fade so well that they are very difficult to notice over time. Internal scar tissue can occasionally form too, which might feel firm or cause a slight change in shape during healing, but there are effective ways to manage it.
This page explains where scar tissue can appear after nose surgery, what is considered normal healing, and what treatment options are available if scars become more visible than expected. With the right surgeon and good aftercare, most patients heal with smooth, natural looking results and very little evidence of surgery.
• Most rhinoplasty incisions heal with minimal visible scarring, especially in closed procedures.
• Internal scar tissue can develop as part of normal healing and usually softens over several months.
• Good aftercare, sun protection, and surgeon-recommended scar treatments help scars fade faster.
• If noticeable scar tissue forms, non-surgical treatments such as steroid injections or laser therapy can help.
• Revision rhinoplasty is only considered for significant or persistent scarring that affects appearance or breathing.
Scar tissue can form anywhere an incision has been made or where major reshaping occurred. This includes both the outside of the nose and the internal nasal passages.
• External scars may appear along the columella (the small strip of skin between the nostrils) after an open rhinoplasty. These scars are usually very fine and fade well over time.
• Internal scar tissue forms inside the nostrils during all rhinoplasty procedures. This tissue is normally hidden and softens over several months.
Patients who have a closed rhinoplasty, where all incisions are placed inside the nostrils, typically have no visible external scar. Open rhinoplasty may be recommended if more complex changes are needed, though even then most patients find the tiny columellar scar becomes barely noticeable once healed.
Internal scar tissue is a normal part of the healing process. Each incision creates a small internal wound that your body repairs with collagen. In most cases, this tissue softens gradually and does not change the shape of the nose or affect breathing.
Sometimes, excess internal scar tissue can form. This may create a firm feeling inside the nose, a slight asymmetry as the tissue contracts, or mild nasal obstruction. Thick scar tissue can appear more frequently in patients who had a large structural change to the nose, or those who experience longer-lasting swelling.
If you notice any tightness, difficulty breathing through one side, or a visible change to the nasal tip or bridge during healing, it is worth discussing with your surgeon. Early treatment often helps keep internal scar tissue under control and supports a smooth final result.
Scar tissue after rhinoplasty is usually caused by a few key factors. The most common one is tension on the skin during the healing process, which can cause your body to produce too much collagen in an effort to repair the wound. This extra collagen can lead to thicker-than-normal scar tissue that can be painful and difficult to get rid of.
Insufficient incisions, or cutting too deeply into the skin, can also create excess scarring. Finally, improper wound care after surgery could leave you exposed to infection, which can lead to additional scarring. By understanding what causes scar tissue after rhinoplasty, you can take proactive steps to minimize its appearance.
Scars never completely disappear, but under normal circumstances, your body is very effective at naturally healing and fading them.
After about a week, you should start seeing a noticeable difference in the visibility of cars and – depending on your skin colour – it may take from 3 to 6 months for them to fade to their final appearance.
It’s possible to reduce the visibility and texture of scar tissue to a nearly imperceptible level over time, and the use of light makeup can usually completely cover them.
Every patient heals at a different pace. It is completely normal for the nose to feel firm, swollen, or slightly uneven in the early stages. Most changes in texture or symmetry are simply part of the tissue settling.
Typical healing timeline
• First 1 to 3 weeks: Scars are pink or red. Internal tissue can feel firm.
• 1 to 3 months: Swelling improves. Scars start to lighten and flatten.
• 3 to 12 months: Internal scar tissue softens. Final nasal shape becomes clearer.
When to contact your surgeon
• Increasing firmness or thick lumps around the tip or bridge
• Breathing that becomes more restricted over time
• A visible bump or pulling that was not present at first
• Signs of infection such as heat, redness, or discharge
Early assessment can allow simple treatment solutions before scar tissue becomes more noticeable.
The most effective way to prevent visible scars after surgery is to choose a plastic surgeon with extensive experience in rhinoplasty. There is simply no substitute for a well-trained and experienced surgeon who knows how to perform the procedure with the utmost care.
Our consultant facial plastic surgeon, Mr Taimur Shoaib, has performed over 19000 surgeries over his career, and his main focus is rhinoplasty, for which he has received several industry awards. We can confidently say that you will be in good hands if you choose to have your nose surgery at our clinic.
Helpful steps
• Keep the incision areas clean as instructed
• Use silicone gel or scar treatments if recommended
• Avoid picking, scratching, or applying pressure inside the nose
• Protect the nose from sun exposure when outdoors
• Sleep on your back with your head elevated to reduce swelling
• Avoid glasses resting on the bridge during early healing
• Stay away from strenuous exercise until cleared by your surgeon
Healthy lifestyle choices such as not smoking and maintaining good hydration support the skin as it repairs.
If scar tissue becomes more prominent than expected, there are reliable treatments to help improve the texture and appearance. Most of these are non surgical.
Non invasive treatments
• Steroid injections: Help soften thick or raised scars and reduce firmness
• Laser therapy: Improves redness, texture, and collagen balance
• Microneedling: Encourages natural remodeling of the scar
• Silicone gels or sheets: Used regularly to flatten early scar tissue
• Massage therapy: Applied at the right stage under surgeon advice
• Nasal strips or taping: Can assist with shaping and swelling control
Your surgeon will create a personalised plan based on how your tissue is healing. Patience is important. Scars often continue to improve for many months.
For patients with large and highly visible scar tissues, revision rhinoplasty may be a solution. A second surgery is only recommended when scarring has a major impact on appearance or function and other treatments are not enough. Revision rhinoplasty requires careful planning and should be performed by a surgeon with extensive nasal experience.
During revision, thick scar tissue can be carefully reduced and the nasal structure refined to create a smoother and more natural look. Expectations are discussed clearly during consultation so patients understand what can be improved and what limitations may remain.
Many patients feel much more confident after revision surgery once the nose has regained a softer and more refined shape.
Most rhinoplasty scars are very difficult to notice once healed. Closed rhinoplasty leaves no visible external scars at all. Open rhinoplasty creates a tiny incision under the tip of the nose which usually fades to a fine, pale line.
Scar tissue continues to soften and change for up to 12 months. Many patients see the biggest improvement in the first 3 to 6 months as swelling settles and scars gradually lighten.
A small amount of internal firmness is normal. If you feel a thick lump, notice pulling of the nasal tip or bridge, or breathing becomes harder through one side, it is worth having a review with your surgeon.
Yes, excess internal scar tissue can narrow the nasal passages. Early treatment such as massage or steroid injections can help improve airflow and prevent longer term issues.
Your surgeon may recommend silicone gel, laser treatment, microneedling, or steroid injections to soften and flatten scar tissue. Proper aftercare and patience are key because scars improve gradually.
There can be a tiny external scar on the columella after open rhinoplasty, but it usually becomes very subtle over time. Most people find it hard to see once the nose has fully healed.
Once the tissue has matured and the healing stage is complete, it is unlikely to return. Following your surgeon’s guidance during recovery helps keep outcomes stable.
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