Concurrent Excision of Dorsal Nasal Scars and Reduction Rhinoplasty: A Retrospective Cross-sectional Study

Omranifard M, Zare N, Mahabadi M.

PubMed 34745799 Publisher (DOI)Free full text (PMC)

What this paper says

In 33 patients, scars on the nasal bridge were cut out and the resulting gap closed using the extra skin freed by simultaneous reduction rhinoplasty, with improvement on scar, satisfaction and breathing measures.

Overview

Skin injuries leave scars on the nose that are hard to repair without further scarring. This study evaluated a technique using the surplus skin left over from a reduction rhinoplasty to cover the defect created by removing the scar. Patients treated between 2013 and 2018 were reviewed retrospectively.

Sections of note

Retrospective cross sectional study of 33 patients who had reduction rhinoplasty for dorsal nasal scars, 2013 to 2018.
Five assessment tools were used: the Cakir surface polygon concept, a visual analogue scale, a patient reported outcome measure, the Stony Brook scar evaluation scale and the SNOT-22.
The number of surface polygons affected by scarring decreased in all patients, P less than 0.05.
Patient satisfaction improved consistently on the patient reported outcome measure, P less than 0.001, and the visual analogue scale, P less than or equal to 0.05.
Physician satisfaction improved on the Stony Brook scar evaluation scale.
Breathing assessed by SNOT-22 showed no adverse effect, P less than 0.09.
The authors conclude scar excision combined with rhinoplasty through the same access is an option.

What it means for a patient

Reducing the nose frees skin that can then close the gap left by removing a scar.
Both scar appearance and patients' own satisfaction improved.
Breathing was unaffected, though the P value reported for that comparison is above the usual threshold.
Thirty three patients without a control group is limited evidence, and the follow up period is not stated.

Why this paper matters

Scars on the nose are hard to excise because the skin there does not stretch, so closing the defect usually requires a flap or graft. This technique uses tissue that a reduction operation makes available anyway. Whether it applies to patients who do not want their nose reduced is not addressed.

Terms

Reduction rhinoplasty: surgery that makes the nose smaller.
Dorsal nasal skin: the skin over the bridge of the nose.
Excision: surgical removal of tissue, here the scar.
Stony Brook scar evaluation scale: a scored assessment of scar appearance by a clinician.
SNOT-22: the Sino Nasal Outcome Test, a 22 item nasal symptom questionnaire.
Cakir concept: a method dividing the nasal surface into polygons to describe its shape.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

Abstract

Unlabelled: Skin lesions and traumas can affect the skin by leaving scars. The purpose of this study was evaluating the results of a new technique in reconstructive surgery of scars on the nose. In this technique, extra skin remaining from reduction rhinoplasty is applied to the defect remained from removing the scar.

Methods: This is a retrospective cross-sectional study performed on 33 patients who underwent reduction rhinoplasty from 2013 to 2018 due to scars on the dorsal nasal skin. Five sets of standards, criteria, and questionnaires were used to evaluate the cosmetic outcomes, scars, and nasal function. These included the Cakir concept, visual analogue scale, patient reported outcome measurement, Stony Brook scar evaluation scale, and sino-nasal outcome test-22.

Results: According to the surface polygon concept, or Cakir concept, the number of affected polygons due to scars decreased in all included patients (P < 0.05). In addition, constant improvement in patients' satisfaction, based on patient reported outcome measurement (P < 0.001) and visual analogue scale (P ≤ 0.05), as well as physicians' satisfaction, based on Stony Brook scar evaluation scale, were determined. Furthermore, evaluating the patients' breathing, based on sino-nasal outcome test-22 criteria (P < 0.09), indicated no adverse effects.

Conclusion: Excision of scars from dorsal nasal skin and conducting rhinoplasty surgery from the same access can be considered an option for reconstructing nasal scars.

Abstract as indexed by PubMed; the article is open access (PubMed Central).