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If a Person Who is Prone to Keloids Wants Plastic Surgery, What Steps Can They Person to Take Reduce the Risk of Scarring?

I am in my mid 20s and I am a black and native American lady. I am thinking about a breast augmentation. I have heard that radiation and steroid injections can be given in the new wounds to prevent scarring. Is that true? I am concerned about the radiation as I don't want to raise my cancer risk but I will definitely consider the steroid injections. How can I find a doctor proficient in dealing preventing scars in ethnic skin? Thanks.

Doctor Answers (7)

If a Person Who is Prone to Keloids Wants Plastic Surgery, What Steps Can They Person to Take Reduce the Risk of Scarring?

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Just because you have Native American and Black ethnicity does not mean that you are necessarily a keloid former.  This is a myth!  I personally have had black patients who have had a breast reduction and tummy tuck with virtually invisible scars, and I have had Caucasian patients who have formed keloid scars.  The tendency to form keloid scars is something you would know, because even a pimple would have ended up in a keloid scar.  So if you were my patient, just to be safe, I would place a small amount of steroid in your incisions before closure, but I would tell you that you do not have a higher chance of forming keloid scars than the average.  By the way, the peri-areolar incision that I almost exclusively use for breast augmentation almost never forms conspicuous scars.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 8 reviews

Keloid scarring treatment options and prevention

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If you are a true keloid former then you are certainly likely to develop this type of abnormal scarring with any incision.  True keloid former will make a bad scar even from stretch marks.  While you are correct that there are treatment options available they do not always control keloid scarring.  The real question is if you have developed keloid scars in the past or have a strong family history of keloid scarring. 

Atlanta Plastic Surgeon
5.0 out of 5 stars 7 reviews

Keloids?

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If you form keloids on other areas of the body, then I would caution you to not go ahead with other elective breast surgery to avoid keloids from occurring.    An incision will always produce a scar.

Manhattan Plastic Surgeon
4.5 out of 5 stars 14 reviews

If a person is prone to keloids what steps can be taken to reduce the risk of scaring

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If you have a strong history of recurrent keloid formation having low dose radiation immediately after your procedure for 3 to 5 days will reduce your recurrence rate to a 2% chance. Even if it does recur, the recurrence will likely be smaller and can be managed most of the time with kenalog injections if you do regular followup. If you do not have a strong history of recurrent keloids, and you just "think you might be prone", I would not recommend the radiation at the first procedure and would treat the wound with continuous topical silicone after surgery. If you do keloid, then they can be excised and the area radiated. Most of the time keloids to not occur in the entire incision so it is best to wait and see where they might occur if at all. Also be sure you know what a keloid really is because I have had many patients say that they are "prone to keloids" and then I find they are calling just a hypertrophic scar a "keloid". The definition of a keloid is an over grown scar that grows outside the original wound edges.

Birmingham Plastic Surgeon
5.0 out of 5 stars 2 reviews

Post Operative Keloid Scarring Prevention

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Thank you for your question. It is widely accepted that the use of staged low dose radiation treatments within 24 hours of surgery will cut down on the chances of the keloids forming post operatively.  This being said, it has been my experience that patients most often associate this with the formation of cancer and apprehension is quite common. Kenalog (steroid) injections are also another course of treatment to aid in the prevention of keloid scarring. In speaking with a plastic surgeon I would definitely express all your concerns regarding treatments and see exactly what he/she would recommend. Make sure that you see a board certified plastic surgeon who has experience with the treatment of keloid formation. I hope this helps you and good luck! Fadi Chahin MD, FACS Plastic and Reconstructive Surgery, Diplomat American Board of Surgery, Diplomat American Board of Plastic Surgery

Beverly Hills Plastic Surgeon
4.0 out of 5 stars 5 reviews

Do you have any keloids?

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Do you have any keloids? If you don't then the risk is minimal. The only way to avoid scars is not to have surgery. Otherwise speak to an experienced plastic surgeon and they will explain the risks and what to do. Radiation and steroids are last things to do.

New York Plastic Surgeon
4.0 out of 5 stars 8 reviews

What Steps Can They Person to Take Reduce the Risk of Scarring?

+1

This will always be a useful topic of discussion between patient and surgeon.Scar creams, steroid injections, certain lasers, irradiation are all methods of treating abnormal scars.

One preventitive that has been shown to be effective in "high risk" patients is the use of silicone sheeting, beginning early in the post op course.

Dealing with keloids and hypertrophic scars is pretty basic stuff. You would be better off concentrating on finding a surgeon experienced in breast augmentation. 

All the best. 

Seattle Plastic Surgeon
4.5 out of 5 stars 28 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.