African American Rhinoplasty: Q&A

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Risks of African American Rhinoplasty to Keloid Prone Patient?

I'm African American considering a Rhinoplasty. I have 3 medium size keloids on my body (not my face). I met a surgeon who suggest it would be better I do not have nostril narrowing on my face to avoid my skin being cut & avoid keloids around my nostrils. I would like your expertise on this matter. Should I avoid at all cost having my nostrils narrowed (cut) since I am proned to keloids? My nasal bone is wide. If I only narrow the nasal bone & raise my columella, will the nostrils & tip look more wide/flared?

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13 Doctor Answers | Asked by Heather123 in NYC

Doctor Answers (13)
Community Comments (0)

Rhinoplasty incisions are not prone to keloid formation.

Keloids are benign, large, unsightly scars that exceed the boundaries of the original incision. You are more prone to get one if your skin is dark, but anyone can get a keloid scar. The other important factor with keloid scarring is location. The ear is, by far, the most common body part to form a keloid. The skin over your breast bone also is prone to develop a thickened scar or keloid. I am not aware of any reported cases of keloid scarring after either circumcision or Rhinoplasty Surgery... more

Eric M. Joseph, MD

197 reviews

West Orange Facial Plastic Surgeon

www.ericmjoseph.com

African American Rhinoplasty and Keloids

Hi Heather, I have never seen a keloid form on the nose in my 12 years of performing African American rhinoplasty. Keloids tend to form mostly on the chest, earlobes, cheeks, neck, arms, abdomen, back and even legs. Keloids do not form on the midline structures of the face. Raising the tip and osteotomies should not have any effect on your nostrils. Best, Dr.S.

Keloids and nasal incisions

Keloids seem to be exceedingly rare to unheard of on the columella and I have never seen one after rhinoplasty. There are, however, rare cases of keloids from piercings of the nasal ala (the outer part of the nostril) such as when studs or other jewelry are placed there. For that reason alone, I would probably avoid any lateral alar base excisions (e.g., Weir excisions). As for whether narrowing the bones would create a disproportion, only an exam in the office would allow for any analysis... more

Keloids are rare after rhinoplasty

I have only seen one case of keloid after rhinoplasty. This was a photo shown to me by a colleague -- the patient had many prior surgeries. I have performed rhinoplasty on many African American patients, and other patients that are prone to keloids, and have not had an issue. With proper surgical technique and postoperative care, you are at little risk for this complication. Most patients can barely see the incision after surgery.

Keloids after Rhinoplasty is rare

Even in African American patients who keloid easily, keloid formation after a rhinoplasty is rare. That being said I have seen it occur. For that reason, if you are worried about keloids occurring I would avoid external incisions including narrowing of the nostrils or alar base. Raising the tip will narrow the nose. You may still have wide nostrils and you can always decide later if you want to do that separately. I hope this information helps.

Scott Trimas, MD

3 reviews

Jacksonville Facial Plastic Surgeon

www.facesonly.com

Keloids should not happen with Rhinoplasty

Hi Heather, You really should not worry about formation of keloid scars after rhinoplasty. I have never seen one nor have any other experienced rhinoplasty surgeons that I know of. That being said, poor scarring can happen after nostril reduction but that usually relates more to poor technique which should not be a concern in experienced hands. If you narrow your nasal bones and do nothing to your tip other than raise the columella, you may find that the bridge now looks narrower in... more

I would not worry about keloid risks in African American Rhinoplasty

I have been operating on African Americans for over 30 years and do noses quite frequently. I have never seen keloid on a nose I have operated on. Let the doctor do what is needed on your nose.

Keloids and rhinoplasty in African-American patients.

In more than 30 years of rhinoplasty, I have never had a patient with a keloid from rhinoplasty--even when they have them elsewhere. Except for Murphy's law, I don't think you would have a problem.

Toby Mayer, MD

7 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Keloid and rhinoplasty (nose job)

In my opinion, the risk of a keloid is exceptionally low with rhinoplasty and almost reportable. That having been said, I understand you concerns. Raising the columella should make the width of the nose appear smaller.

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Rhinoplasty

I believe you are correct in that if you narrow the nasal bones and leave the nostrils wide, you will look disproportionate. We call this the "bowling-pin" nose. The risk of a keloid on the nose or after alar narrowing is very, very, very rare. Despite the fact you have three keloids elsewhere on yourself, you risk of bad scarring, assuming meticulous surgical technique, would be very low. All the best, "Dr. Joe"

Keloids after Rhinoplasty

Hi Heather, Great question and a valid concern. While no absolutes can be given, in general, the incident of keloid scaring after rhinoplasty is very rare. For some unknown reason, keloids don't form after treatment on the nose. As you may know, the most common places for keloids are the ears, neck, and chest. I wouldn't let the fear of keloids stop you from having rhinoplasty surgery. Best wishes for your surgery.

Keloid formation minimized with closed rhinoplasty and cortisone shots

The chance of developing keloids on the nose is very rare. We have never seen it in private practice after performing thousands of rhinoplasty surgeries. The ethnic rhinoplasty can be done through a closed technique whereby all the incisions remain on the inside of the nose, which completely alleviates any keloid formation. Weir excisions placed at the nostril sill could potentially cause keloids. However, a cortisone shot to the nostril sill during surgery can prevent keloids from... more