I've read that African Americans are more suceptible to forming keloids scars after plastic surgery. Is this true? Can it be prevented?
Are African Americans More Prone Keloids After Plastic Surgery?
Doctor Answers 4
Scarring in African Americans
There are some skin types that are more prone to forming keloid scars: African American, Mediterranean, Indian, Hispanic, for instance. There are also body areas that are more prone to form keloid scars: the mid-sternum, shoulders, back, earlobes, for instance.
But this does not mean that all African Americans form keloids. In fact, most do not, and do just fine after plastic surgery procedures. In my practice, we use early scar interventions to reduce the formation of poor scars. Some people still end up needing scar revisions, but at least I know we've done everything we can do make the scar as good as it can be.
African Americans and Keloids
In general, African Americans, Asians, and Latin Americans are at greater risk for keloid formation than Caucasians. The areas where keloids are most likely to form on a statistical basis are the sternum (chest), deltoid, and earlobe/ peri-auricular areas. This is not to say that keloids are an inevitable consequence, because many African Americans are not at risk for and do not form keloids. Whenever I see an African American patient who is considering a Facelift, I look to see if the patient has had ear piercings and I ask about family history of keloids. If the patient has been able to tolerate a piercing without keloid formation and describes no family history, the likelihood of keloid formation in the presence of an uncomplicated Facelift are low.
Keloids are more prone in certain ethnic groups. African-Americans can develop them as well as some Hispanic patients, as well as patients of mediteranean descent. Usually patients know before hand if they form keloids from prior injuries.
Keloids in African Americans undergoing plastic surgery
If you look at the entire population of people with keloids you find a greater percentage of darker skinned indiviuals-African, Indian etc. than you do white caucasians. That does not mean that in individual African American is more susceptible to forming keloids after plastic surgery. The vast majority of keloids that I have seen were due to ear piercings and acne. The few keloids I have seen after surgery were mostly in the lower abdomen after gynecologic surgery. I have performed cosmetic surgery on a large number of African Americans and do not remember any them getting a keloid after surgery.
My approach to this is identify those who are at risk (not just on the basis of race) and take appropriate preventative measures.
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