Feb 28

I read your recent blog about rhinoplasty in African American patients but I have a problem with keloids and was wondering how big of a problem this will be if I do have rhinoplasty.

Your concerns are valid and it is important to discuss your history of poor scarring whenever you undergo any type of surgery. You should note however that different parts of the body will heal differently. The simple answer is that keloids rarely develop in the central face and we here at Profiles have never seen a keloid develop after we have done rhinoplasty.

A more in depth explanation begins with an explanation of scarring. First, we need to help you in understanding the difference between a hypertrophic scar and a keloid. Clinically, hypertrophic scars are enlarged scars that stabilize or shrink with time. Keloids, however, initially develop as hypertrophic scars but later extend beyond the original injury area. They rarely regress on their own and have a propensity for recurrence after excision.

Keloids may affect virtually any surface on the body with the central chest, deltoid/shoulder region, and back having the highest frequency. And this has led some doctors to speculate that motion and tension play a large role in causing keloids to develop. While this may be true to some extent, the earlobes, which are one of the most frequent sites affected, are obviously subject to minimal motion or tension forces.

photos Before and After Earlobe Keloid Scar Excision

photo Before and After Earlobe Keloid Scar Excision

This African American patient demonstrates a typical example of a large keloid scar of the earlobe that was removed in one session with flap reconstruction of the back of the ear. The After photo to the right shows her postoperative result over 6 months after the procedure.

All this being said, while you should explore this issue with your doctor before surgery, you should feel some comfort in knowing that the nose is rarely a site for keloid development after rhinoplasty or nasal surgery. In fact, we did a literature review to check on your answer and were unable to find any papers which could point to a case of a keloid after rhinoplasty.

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5 comments

5 Comments so far

  1. Loose Fat February 2nd, 2009 8:22 pm

    Great site. Keep up the great work. Thanks again, Jonathon

  2. Deanna February 6th, 2012 9:34 am

    Great information, definitely addresses some of my concerns for future rhinoplasty.

  3. Keloid Scar May 27th, 2012 10:44 pm

    I really enjoyed this post. You explain this topic very well. I really love your blog and I will definetly bookmark it! Keep up the super posts! [:)]

  4. Kathy June 20th, 2012 11:48 am

    I have a keloid on my neck its big im tired of it now. i had so many surgery and it keep coming back.

  5. admin September 7th, 2012 10:00 am

    Hi Kathy,

    Sorry to hear about your recurrent keloid on your neck. It can be a very frustrating problem for patients and surgeons. But, don’t give up. There are various options available for reducing new formation of keloids and you should talk to an experienced plastic surgeon to review your options.

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