LAM FACIAL PLASTICS

Dear Dr. Lam,
I read your response to a post in january about a dent in a lady's nose from a laser, i have a recess just' above the tip" of which i've had a very conservative scar revision, the surgeon says he can get more of the scar and bring the edges closer together because there is still laxity in the skin. I've read alot about this procedure and i'm confused because many drs claim linear closures can be very successful for small defects, even on the tip. I will send 4 photos one outlining where the dr says he can revise again. I had filler, which didn't really help and a small amount of dermabrasion already. It is not that deep but the texture and the recess bothers me.
I await anxiously your response and thank you for being a kind and empathetic surgeon.
thank you!

your photos are blurry but i get a sense of what is going on. i would personally try fillers but if you failed then perhaps it was more technique than product. i typically use silicone to improve that area. if that fails, then yes surgery can help if it is small enough but as you probably know from what i have said in other posts, you must go below the skin surface and below the muscle above the bone layer and undermine (release) tissue from side of the nose to top of the nose for two reasons. you must have no tension by releasing this plane of tension free-ness and also allow the skin flaps to rotate more easily with better blood supply. if the tissues continue to get cut in the wrong plane, you will make any future attempts much worse.
best,
sml