I have keloid scarring, what are my options for facelift? about 20 years ago I had several moles removed, two on my face. I discovered then that I have keloid scarring. They had to do a dermabrasion on the two on my face because they scars were raised up. They were located around my mouth. you can still see scars...
Facelift Options for Patient with History of Keloids?
Doctor Answers (12)
Keloids Scars & Facelift
If you have a history of keloids from a previous facelift, I would be very contemplative on doing further operative intervention and may seek other alternatives if you had true keloids.
Facelift in a Keloid patient?
If you trully have facial keloid and not hypertrophic scars I woudl avoid having a facelift as the complication are not worth the potential gain.
Keloids and facelift options
If you truly have keloids, it is probably not facial keloids. The key distinction is whether they are hypertrophic scars or true keloids. See an experienced facial plastic surgeon for an evaluation.
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Essentially individuals who have true keloid formation need to be extremely careful about consideration for facelift surgery. Of course with rhytidectomy surgery there are incisions in and around the ear and any incision can be subjected to the processes of keloid formation in those individuals who form keloids. Some individuals do have minor hypertrophic scars or widened scars that are not true keloids, and might do well with facelift surgery, but essentially it is difficult to predict the ultimate way in which the incisions will heal. Some consideration to performing a trial incision in and around the ears has been described by some physicians. Essentially an incision behind the ear performed as a test incision and observing over a six-month to one year time period as to whether this forms a keloid or not.
However, caution has to be raised with this test incision as in real surgery the incisions are exposed to more tension and irritation and even with a negative test spot a keloid could still form. Good physicians will perform facelift surgery with minimal or no tension, but essentially this does not guarantee against a keloid. Generally if you are a true keloid former, abstaining from a facelift surgery is probably the best answer. Once keloids form, they are difficult to resolve. The can be improved with various measures including laser treatment and surgical excision, steroid injections and topical silastic gel sheeting type therapy. The best treatment is avoidance of keloid formation by avoiding the surgery.
Facelift and Keloids
In 35 years I've never seen keloids form in in facelift incisions around the ears. Keloids do form in the ear lobes, but the lobes are carefully avoided during the facelift. I would proceed carefully with an experienced surgeon.
It is unusual for a person that forms keloids to have keloids after a facelift. Bad scars may occur-raised, red, spread- but usually only in back of the ears. It sounds like you form hypertrophic scars though and not keloids. The former usually responds to cortisone injections or laser therapy.
Facelift options for patient with history of keloids
If you are a "true" keloider than see in person boarded surgeons. I would be very careful because once you cut and heal with a keloid than it is very permanent.
From MIAMI Dr. B
Facelifts in patients with keloids.
You should see an experienced facelift surgeon, since you probably would heal fine. True keloids are not common in front of the ear, but are seen behind the ear in dark skinned people. In fair skinned people, I have only seen wide scars due to the surgeon placing too much tension on the skin!
Scarring after Facelift
The location of the scars after a facelift do not usually thicken or develop into keloids. Keloids are really unusual in that area of the face, it is most likely a hypertrophic scar which is easier to manage.
Risk of Ugly Scarring in Cosmetic Surgery
The public describes the vast majority of ugly scarring as "Keloids". In fact, the great majority of raised, speed bump like scars are HYPERTROPHIC scars NOT Keloids. Hypertrophic scars are more common in certain ethnic groups, in certain areas of the body, when the incision or injury are oriented in a certain way, when there is tension on the wound, when the wound is exposed to UV light etc,
The basic philosophy of Cosmetic Surgery should be that if you are absolutely NOT willing to risk ANY of its complications you should not have the procedures. Although the likelihood of such complications is very low - it will be unacceptable IF it happened to you. Since a Facelift is a Cosmetic operation that you could live without and if you did not want to tolerate any risk of poor scarring, even if the likelihood of such scarring is low, I would seriously consider having it.