African American worried about getting keloid scars after Open Rhinoplasty - what are the risk of getting a keloid?

I'll be having an open rhinoplasty, and I'm really scared that my face would be destroyed by keloids. I've already spoke to my surgeon and he told me that there could be a risk that my scares leave keloids, especially in an open rhino for a Afro. Could tell me more about that please?? Thank you

Doctor Answers 8

Avoiding keloids with African American rhinoplasty

Thank you for asking about your African American rhinoplasty.

I understand your concern.
  • Have you had your ears pierced? If so, and if you did not form keloids, chances are you will not.
  • We do not understand keloids.
  • If you are having your nostrils reduced, you cannot avoid an incision in your skin.
  • But if you are only having the bridge raised and the tip refined, it can be done through a closed rhinoplasty - which means no skin incisions.
  • Discuss this possibility with your surgeon.
  • And if you are having nostril reduction, discuss the possibility of a test incision first, to see how you heal.
  • Although keloids are uncommon in the central part of the face - they can occur.
  • Your concern should be taken seriously.
Always consult a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

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Keloiding after surgery

Keloids, or raised scars that grow outside the bounds of injury, are more common in African-American and Asian populations, and seem to have a genetic predisposition.  They are different from hypertrophic scars, or raised scars that stay within the area of injury.  Hypertrophic scars are common in areas of high tension (shoulder, back, etc).  Thankfully, the central face and the nose seem to be spared from keloid formation.  While it is a possibility, I have not seen rhinoplasty-related keloid formation in my practice and have heard other rhinoplasty surgeons discuss the absence of rhinoplasty keloiding in their practice at meetings.  A review of the rhinoplasty literature describes a few hypertrophic scars in African-American rhinoplasty patients, but no keloids.  Close follow-up with your rhinoplasty surgeon, with consideration of steroid and or 5-fluorouracil injections for raised or hypertrophic scars, should improve the chances of a good outcome.  Good luck!

Inessa Fishman, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Possibility of Keloids

Most individuals who are at high risk of keloid formation know they have a healing problem long before presenting for Rhinoplasty. True keloid formers respond to even trivial trauma with an exaggerated formation of scar. Scratches and minor lacerations will demonstrated larger scars than would be anticipated. If you do not have true keloid scars it is highly unlikely you will have any scar issues with open Rhinoplasty. Nothing is 100% but I have yet to see even hypertrophic scarring in an open Rhinoplasty.  Best of Luck  Dr Harrell

Jon F. Harrell, DO
Miami Plastic Surgeon
5.0 out of 5 stars 36 reviews

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African American worried about getting keloid scars after Open Rhinoplasty - what are the risk of getting a keloid?

  I perform closed rhinoplasty to avoid that scar.

Kenneth Hughes, MD

Los Angeles, CA.............................

Keloid

Honestly, I have never seen (25 years) or heard of a keloid in an open rhinoplasty. While I suppose it is not impossible, it must be VERY unlikely.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.5 out of 5 stars 37 reviews

In our practice, we have not seen keloid scarring at the nasal base in any African American patients.

When it comes to keloid scarring, the most important factor is location, location, location. Some areas of the body, like your ears, are prone to keloid scarring regardless of skin type. With an uncomplicated open rhinoplasty procedure, your risk of developing a keloid scar is remote at best.

Hope this helps you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 306 reviews

African American rhinoplasty surgery performed through closed rhinoplasty techniques

If you're concerned about keloid formation, then perform closed rhinoplasty techniques were all the incisions are placed inside the nose. This alleviates the keloid issue completely. 

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Keloid after open rhinoplasty

I have done many rhinoplasties on many different skin types, including numerous African Americans.  The risk of keloid formation at the incision is relatively low as long as there is not excess tension put on the wound at the time of closing the incision.  Anecdotally, the only keloid that I have seen was in a patient that had numerous surgeries, one of which was complicated by infection.  That patient was Caucasian.  I would trust your surgeons experience in the matter. 

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.