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

I am an African American considering rhinoplasty surgery, but I have a problem with Keloids. Am I still a candidate?

Doctor Answers 35

Keloid scarring is not common with rhinoplasty surgery

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Your concerns are valid and it is important to discuss your history of poor scarring whenever you undergo any type of surgery. You should note however that different parts of the body will heal differently.

The simple answer is that keloids rarely develop in the central face and we here at Profiles have never seen a keloid develop after we have done rhinoplasty. A more in depth explanation begins with an explanation of scarring.

First, we need to help you in understanding the difference between a hypertrophic scar and a keloid. Clinically, hypertrophic scars are enlarged or thickened scars that stabilize or shrink with time. Keloids, however, initially develop as hypertrophic scars but later extend beyond the original injury area. They rarely regress on their own and have a propensity for recurrence after excision.

Keloids may affect virtually any surface on the body with the central chest, deltoid/shoulder region, and back having the highest frequency. And this has led some doctors to speculate that motion and tension play a large role in causing keloids to develop. While this may be true to some extent, the earlobes, which are one of the most frequent sites affected, are obviously subject to minimal motion or tension forces.

All this being said, while you should explore this issue with your doctor before surgery, you should feel some comfort in knowing that the nose is rarely a site for keloid development after rhinoplasty or nasal surgery. In fact, we did a literature review to check on your answer and were unable to find any papers that point to a case of a keloid after rhinoplasty.

Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 51 reviews

Keloids are very rare on the nose

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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

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Keloid formation is generally not a problem with...

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Keloid formation is generally not a problem with rhinoplasty surgery. For some reason, incisions which are made in or close to the midline of the face don't seem to have a keloid problem. As always, discuss your concerns with your physician to ensure that all of your questions are answered.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 reviews

Keloid formation after rhinoplasty is extremely rare

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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. 

Keloid Scarring Not Likely on the Nose

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Keloid scarring is extremely unlikely on the nose.  The reason for this is not known, but it is certainly an observed fact.

If you want to further reduce your chance of keloid scarring, see if you can't have a "closed" rhinoplasty in which all of the incisions are kept inside of the nose.

Keloid is Rare With Rhinoplasty

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Fortunately, keloid formation is rare with Rhinoplasty.

Do mention your concern to your surgeon at the time of your consultation.

Keloid scarring risk in Rhinoplasty

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Although the risk of developing keloids on the nose is rare, anyone with a history of keloids should be advised against any elective surgery, especially on the middle of the face. I am very conservative in my practice and would advise the patient to take the safest road to prevent devastating complications.

Keloid scarring is not a problem with rhinoplasty...

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Keloid scarring is not a problem with rhinoplasty surgery since all of the incisions are placed internally or inside the nose. Patients with thick, olive, oily skin can develop edema just above the tip with some scar contracture underneath the tip. These complications can be averted through cortisone injection treatment during the first three months after rhinoplasty.

Keloids after rhinoplasty

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Patients with darker skin tones are more likely to get keloids. Keloids tend to be more common on specific parts of the body such as the ear and chest. While keloids on the nose are possible they are much less common on the nose after rhinoplasty even in patients who do have a keloid history. The risk is not zero but it's low. 

Jeffrey Jumaily, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 16 reviews

Keloids and Rhinoplasty Surgery

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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.

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.