How Big of a Problem is Keloid Scarring with Rhinoplasty Surgery?

I have not seen a rhinoplasty-related keloid in my 27 years of practice.
With African American rhinoplasty, usually an external approach is used which involves a small inverted V incision under the columella (tip). The remainder of incisions are inside of the nose and have no danger of keloid formation.
It would be a good idea to inject your incision line with a tiny amount of Kenalog 10 after the wound heals.
Be well and good luck.
Dr. P

Hi from Istanbul! I empathize with your concerns regarding keloids and rhinoplasty, since certain skin types are more prone to this type of scarring. Especially in ethnic rhinoplasty and thick-skin rhinoplasty patients specific measures are taken to optimize skin quality, reduce the risk of scars, and encourage optimal healing. This is a particular area of our expertise. Notably, in both my hands-on experience and from the literature I've reviewed, keloids haven't developed after a rhinoplasty procedure. Make sure that your chosen surgeon has extensive expertise in African American rhinoplasty, who can provide more information after an in-person consultation. Wishing you the best on your journey!

It is extremely rare for keloids to form in the central part of the face. I have never seen or heard of a problem with them following rhinoplasty.

Keloid scars are excessive scars that form not only in the area of the trauma or injury but abnormally extend to the surrounding tissues. They are more common in areas such as the shoulder or sternum (over the breast bone), and can also occur at the ear lobes and nape of the neck. There seems to be a genetic predisposition as people with darker skin tend to form keloids.However, keloid formation on the nose is EXTREMELY rare and is almost unheard of after rhinoplasty. The only exception may be the case of nasal reconstruction for major burns of the nose.

All individuals with brown skin have some propensity to producing thick scars, though you're right to be concerned as an african american since the incidence is higher.  Having said that, keloid formation at the site of incision during rhinoplasty is almost unheard of and exceedingly rare.  Some patients can get mild thickening very rarely, however, this is easily treated with time, massage, and sometimes, cortisone treatment.  Thickening of the scars around the nostrils for alarplasty is probably more common but as a rhinoplasty surgeon who performs a large number of african american rhinoplasties, I have not seen keloiding here either. 

Having done over 1,500 rhinoplasties in all ethnic groups, I have never seen a true keloid scar in an ethnic patient from an elective rhinoplasty procedure. I am not saying that it cannot or will not happen, but I have not seen it personally on the nose in well over 1,000 rhinoplasty patients.

I have never witnessed, or seen described in the literature, keloid formation after rhinoplasty, even in individuals who are prone to keloids in other areas of the body such as the arms/legs, trunk, or earlobes. The reason for this is not well understood. When it comes to African-American rhinoplasty, often an open approach is required to create the tip projection and refinement desired by the patient. The tiny incision across the columella in this open rhinoplasty approach heals extremely well in people of all ethnic groups and skin types. 

I have never seen a keloid after Rhinoplasty in my hands, during my training, or in my community.  Keloids more commonly form on the sternum, deltoid, and earlobe region.

I personally have never seen a keloid on anyone's nose.  I am sure that it has been reported somewhere but it has to be a rare condition.  I don't think I would let the remote possibility of keloid be a big determinant in choosing a rhinoplasty.

The scar usually heals remarkably well on the nose after a rhinoplasty.  Keloids do not typically form in this area and are not usually a concern with a rhinoplasty incision.  If you are prone to form keloids (thick,raised scars) in other areas of your body (chest, shoulder, ear) let your plastic surgeon know prior to surgery.

Best wishes,

Dr. Bruno

I have never seen, or even heard of, a case of keloid formation after rhinoplasty surgery. This is even if an external rhinoplasty incision is needed. Bottom line is that your keloid history doesn't preclude you from having rhinoplasty surgery in the future.