I am an African American considering rhinoplasty surgery, but I have a problem with Keloids. Am I still a candidate?
How Big of a Problem is Keloid Scarring with Rhinoplasty Surgery?
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African American Rhinoplasty and Keloids
I have performed hundreds of African American Rhinoplasties and have never encountered a keloid post-operatively. Keloids tend to stay out of the T zone of the face and are more commonly found on the periphery of the face.
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Keloid scarring is not common with rhinoplasty surgery
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.
Keloids are very rare on the nose
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.
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Keloid formation is generally not a problem with...
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.
Keloid formation after rhinoplasty is extremely rare
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.
Keloid is Rare With Rhinoplasty
Fortunately, keloid formation is rare with Rhinoplasty.
Do mention your concern to your surgeon at the time of your consultation.
Keloid scarring not an issue with rhinoplasty
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.
Keloid scarring risk in Rhinoplasty
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.
Keloid scarring is not a problem with rhinoplasty...
Keloid scars after rhinoplasty in black patients
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.
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.