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!
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
I perform closed rhinoplasty to avoid that scar.
Kenneth Hughes, MD
Los Angeles, CA.............................
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.
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.
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.
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.