Not all skin is the same. The different types of skin have been classified regarding their color and reaction to sunlight (click Skin Types for more information). In this section you will find answers to questions that people often have regarding hypertrophic scars and keloids.

It is important to remember that all surgeries require wound closures and all wound closures create a scar. The quality, aspect and thickness of the scar, varies in individuals, and luckily a 95% of people heal normally, independent of the color and thickness of their skin.

However, there are some cases where wound healing occurs in an exaggerated manner that gradually causes over-growth in mass and volume often producing itching as well. This type of scar is called a Keloid. There are varying degrees of keloid formation. Some scar tissue may be minor in its exaggerated growth and others may be very aggressive, progressing to the point that the scar becomes thick and raised. In this case, the original wound edges invade surrounding skin tissue.

The exact cause of keloid formation is not known but there is usually a genetic, racial or familial predisposition. Therefore, if a patient of Aesthetic Surgery happens to get a keloid, it is not the fault of the surgeon, or the patient’s. It does not indicate that something unusual happened during surgery, or that the patient did not comply with the Plastic Surgeon’s instructions.

Prior to performing a surgical procedure the Plastic Surgeon will examine any previous scars you may have particularly in shoulders, chest, neck, chin and earlobes. This is an indirect method to assess the possibility of keloid formation following your surgery. If signs of a keloid are not present or if you have never had surgery, there is no way to know if a keloid could develop. Nevertheless, the possibility is minimal.

If a keloid does occur following surgery, there are three ways to treat it. These measures These may be singular or done in combinations to control keloid growth and improve the overall outcome:

  • 1- Oral medications
  • 2- Cortisone injection within the scar
  • 3- Therapeutic low-grade radiation to the scar

Surgical intervention to remove a keloid scar is not recommended as keloids are recurrent. With the reappearance, the new keloid is usually more aggressive than the one that was removed. Therefore, only the three alternatives listed above can be used to successfully treat a keloid scar.

There is another type of scar that looks very much like a keloid called a hypertrophic scar. It is not a keloid. A hypertrophic scar is produced when a wound is closed with too much tension on the wound edges or as the result of foreign material or infection in the wound. The growth of a hypertrophic scar is less exaggerated than a keloid and in most cases, is easier to control.

Following are some examples of keloids and hypertrophic scars that I have seen over the years of my practice:


Keloid in a Thyroid operation scar

Keloid in the chest, after acne manipulation

Luckily the occurrence of this type of scarring is rare. Since treatment for prevention of both keloid and hypertrophic scars is available, there is no need to abandon the idea of your surgery for fear of developing one. In the unlikely chance of one occurring, it can be effectively controlled post-operatively.

Please, feel free to call the office for questions about this or other topics concerning your Plastic Surgery request.

Any doubts about this surgery, please call the office, 684-2551  (US: 619-730-1917) or my cell 664-283-0976. We wish you a speedy recovery and an excellent experience with your esthetic lid surgery, send an email or click Contact us for more information.

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