White-red bumps in my suture line after Asian blepharoplasty—keloid/hypertrophic scar?

Question

I’m female, asian, 27 years old, with clinical genetics of a familial keloid. I had lower blephoplasty with fat transposition around 10 days ago. I actually noticed a white-reddish bump along the suture line of my right under eye on day 8 after suture removal. I’m assuming this might be scar tissue due to the delayed time of suture removal. I’m curious, is this potentially hypertrophic scar? Would it develop into a keloid after 3 months? Any recommendations to lessen the additional scar tissue?

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

It's understandable to be concerned about changes in your suture line following surgery, especially with a familial history of keloids. Based on your description, the white-reddish bump could be a sign of early scar formation. Here's some information and recommendations:

Hypertrophic vs. Keloid Scars:

Hypertrophic scars typically remain within the boundaries of the original incision and may improve over time.
Keloid scars extend beyond the original wound margins and can become more prominent over time. Given your family history, there is a potential risk for keloid formation.
Early Signs:

At 10 days post-surgery, what you're observing could be initial scar tissue formation. It's early to definitively categorize it as hypertrophic or keloid.
Prevention and Management:

Silicone Gel or Sheets: These can help minimize scarring by keeping the area hydrated and protected.
Pressure therapy: Applying gentle pressure can sometimes help flatten scars.
Avoid Sun Exposure: Protect the area from the sun to prevent pigmentation changes.
Topical Treatments: Over-the-counter products with ingredients like onion extract (e.g., Mederma) may help improve the appearance of scars.
Consult with Your Surgeon: Follow up with your surgeon for personalized advice. They might suggest treatments like steroid injections if a keloid begins to form.
Monitoring:

Continue to monitor the area. If the bump grows or changes significantly, or if you have concerns, it's important to consult with your dermatologist or surgeon.
Early intervention can be crucial, especially with a predisposition to keloids, so keeping in touch with your healthcare provider is key.

White-red bumps in my suture line after Asian blepharoplasty—keloid/hypertrophic scar?

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White-red bumps in my suture line after Asian blepharoplasty—keloid/hypertrophic scar?

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Everything you need to know about Scar Removal

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