How Big of a Problem is Keloid Scarring with Rhinoplasty Surgery?

I am an African American considering rhinoplasty surgery, but I have a problem with Keloids. Am I still a candidate?

Doctor Answers (32)

Keloid scarring is not common with rhinoplasty surgery

+6

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 or thickened 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.

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 that point to a case of a keloid after rhinoplasty.


Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 23 reviews

Keloids are very rare on the nose

+4

I have not seen a rhinoplasty-related keloid in my 27 years of practice.

With African American rhinoplasty, usually an external approach is used which involves a small inverted V incision under the columella (tip). The remainder of incisions are inside of the nose and have no danger of keloid formation.

It would be a good idea to inject your incision line with a tiny amount of Kenalog 10 after the wound heals.

Be well and good luck.
Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

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Keloid formation is generally not a problem with...

+3

Keloid formation is generally not a problem with rhinoplasty surgery. For some reason, incisions which are made in or close to the midline of the face don't seem to have a keloid problem. As always, discuss your concerns with your physician to ensure that all of your questions are answered.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
4.0 out of 5 stars 12 reviews

Keloid formation after rhinoplasty is extremely rare

+2

I have never witnessed, or seen described in the literature, keloid formation after rhinoplasty, even in individuals who are prone to keloids in other areas of the body such as the arms/legs, trunk, or earlobes. The reason for this is not well understood. When it comes to African-American rhinoplasty, often an open approach is required to create the tip projection and refinement desired by the patient. The tiny incision across the columella in this open rhinoplasty approach heals extremely well in people of all ethnic groups and skin types. 

Umang Mehta, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 26 reviews

Keloid is Rare With Rhinoplasty

+2

Fortunately, keloid formation is rare with Rhinoplasty.

Do mention your concern to your surgeon at the time of your consultation.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 12 reviews

Keloid scarring not an issue with rhinoplasty

+2

The scar usually heals remarkably well on the nose after a rhinoplasty.  Keloids do not typically form in this area and are not usually a concern with a rhinoplasty incision.  If you are prone to form keloids (thick,raised scars) in other areas of your body (chest, shoulder, ear) let your plastic surgeon know prior to surgery.

Best wishes,

Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 141 reviews

Keloid scarring risk in Rhinoplasty

+2

Although the risk of developing keloids on the nose is rare, anyone with a history of keloids should be advised against any elective surgery, especially on the middle of the face. I am very conservative in my practice and would advise the patient to take the safest road to prevent devastating complications.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 47 reviews

Keloid scarring is not a problem with rhinoplasty...

+2
Keloid scarring is not a problem with rhinoplasty surgery since all of the incisions are placed internally or inside the nose. Patients with thick, olive, oily skin can develop edema just above the tip with some scar contracture underneath the tip. These complications can be averted through cortisone injection treatment during the first three months after rhinoplasty.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Keloid scars after rhinoplasty in black patients

+1
Keloid scars are excessive scars that form not only in the area of the trauma or injury but abnormally extend to the surrounding tissues. They are more common in areas such as the shoulder or sternum (over the breast bone), and can also occur at the ear lobes and nape of the neck. There seems to be a genetic predisposition as people with darker skin tend to form keloids.

However, keloid formation on the nose is EXTREMELY rare and is almost unheard of after rhinoplasty. The only exception may be the case of nasal reconstruction for major burns of the nose.

Jamil Ahmad, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 6 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.