Twelve Steps to Optimize Scar Outcomes in External Rhinoplasty

Overview

The visible scar of open rhinoplasty crosses the columella. The authors (including Apaydin) describe a complete closure method combining vertical mattress and interrupted simple sutures in 12 defined steps, and assessed scars in 104 patients with standardised photographs and the Vancouver-Manchester scale (notching, skin level difference, pigmentation, overall appearance).

Sections of note

• 104 patients, open rhinoplasty, all closed with the proposed technique.
• No scars classified as poor; 83.6% good.
• 65.5% of good scars achieved the maximum 6-point score.
• One moderate scar scored 3 points.
• The authors note the technique did not achieve a 100% imperceptible rate.

What it means for a patient

• With careful closure, most open rhinoplasty scars become nearly invisible, but not all.
• Closure technique is one of the things worth asking a surgeon about if the scar concerns you.
• The study has no comparison group, so it shows what the method achieves rather than that it beats other methods.

Why this paper matters

It gives a reproducible, step-by-step closure protocol with measured scar outcomes in a reasonable series. Limits: single group, no control, scar rated by the operating team, follow-up interval unstated.

Terms

• External (open) rhinoplasty: an approach using an incision across the columella.
• Columella: the strip of tissue between the nostrils.
• Vertical mattress suture: a stitch that everts and aligns skin edges precisely.
• Vancouver-Manchester scale: a scar rating combining features such as colour, height and pliability.
• Notching: a visible step or indentation along the scar.