Facelift for Patient Prone to Keloids?

Keloids and hypertrophic scars ( a similar but distinct raised scar) can occur in some patients after a facelift.  It is not possible to predict which patients will develop a keloid or raised scar after the procedure.  Surgeons should avoid tension on the skin, meticulous close the incisions, and have long term follow up with the patients to ensure scar formation is minimized.   In patients with a higher likelihood of keloids, consideration can be made to a limited... more

These procedures have a low rate of hypertrophic or keloid scar occurence, in my opinion.  Treatment should focus on minimizing tension and proper wound healing postoperatively.  I would recommend surgery. 

I would approach the facelift cautiously in a patient prone to keloids.  Deciding whether to perform the surgery or not.  If the patient understands the downside of the cosmetic result then facelift may be done and steroid injections and/or silicone sheeting performed to minimize keloid formation. Concerning the eyelids, keloids rarely if ever form from an incision in the delicate eyelid skin. Dr. ES

Indeed you can have a facelift if prone to keloids, however, both the patient and the surgeon must understand that there is a very small risk that you can get a keloid from a facelift. Only dark-skinned and Asian patients are susceptible to this. It is important that cortisone shots are placed in the incisions at the time of the surgery and very close following and monitoring postoperatively for occurrence of these keloids can be done. Sequential injections of steroids at a month and... more

I would agree with most of the comments. Keloid type scarring is possible but usually does not occur even with a history of keloids elsewhere on the body. Exacting surgical technique is extremely important. Unfortunately, no one could give you a 100% guarantee that a keloid would not occur. It may be worthwhile doing a small facial procedure at first just to see how you feel.

 In 30 years I have never seen keloids of the eyes or facelift. I have seen wide scars due to too much tension on the skin. Going to an experienced facelift surgeon should give you what you want without keloids.

If you developed a keloid after a burn or cut on the chest or back, it means little because almost everyone will keloid there. Keloids on the face are infrequent in most patients unless they are black or of very dark genitic background. Eyelids almost never keloid unless it is the result of a burn. Facelift scars can keloid, but usually can be managed by injection of cortisone. The way the incision is located in a facelift greatly influences its ability to form a keloid. Good Luck.... more

Eyelids rarely if ever keloid. However, if you are a true keloid former, not just hypertrophic scars, facelift that use incisions around the ears can have problematic scars. Even in non-keloid patients, hypertrophic scars can appear around the ears or back of the neck. Discuss the relative risks carefully with your surgeon. Perhaps there are other methods to get you close to what you want without undue risk of unsightly keloids.

Facelift scars are usually very inconspicuous. However, if you are prone to keloids, you may have a problem with the portion of the facelift scars that extend from behind the ears to the upper neck hairline. In order to aviod incisions in this area, you should consider a short-scar facelift, also called mini-facelift or S-lift. With this technique, we can improve the contour of the cheeks, jowls, and jawline, while limiting the extent of the incision behind the ears. However, if you... more

It is a difficult choice. I would be tempted to minimize scars a s much as possible. A short scar face lift could be an option.  An eye lift could be done from the inside of the eye or with a small incision below the eye lid. In general, this incision does not keloid badly. Best of luck!