Will removing a mole on my chest produce a keloid scar?
Any tension area such as the chest does have an increases incidence of development of a keloid after any kind of trauma. Although anyone can develop a keloid, there are individuals who have a predisposition to develop keloids. So if you have developed a keloid previously your chances may be increased.
The shave excision you mention is probably the best way to have the moles removed because healing by secondary intension would decrease the tension in the area.
There are also some topical preparation now available including silicone based products such a PracaSil gel that may be helpful in decreasing keloid formation. In addition topical combinations that include tranilast in a Silicone base with various combinations of other agents including topical steroids, tamoxifen and levocetriizine offered through compounding pharmacies may also be helpful in improving the final scar
Keloid after mole removal
Delicate shave removal of moles does not produce keloids in the vast majority of people. With that said, certain people are more prone to keloids. If you have a history of keloids-- I would avoid this procedure, or at least have keloid prevention treatments before and after (such as injection of a steroid into the wound) the removal.
Keloids are also more common in the chest and in African-Americans-- though most people will not keloid.
Be sure to consult with a Dermatologist knowledgeable with the cosmetic removal of moles as well as the evaluation of risk, and prevention of, keloids.
Removing chest moles shouldn't be done casually
First of all, if the moles are at all suspicious, then they should be removed and sent to pathology, and the scar considerations become secondary. However, if these moles (nevi) are longstanding, haven't changed, and are more of a cosmetic concern, then be careful. Removing moles from the front center of the chest (as opposed to the breasts, or side of the chest), or for that matter creating scars for any reason in this area, can produce a thick ugly scar. These are generally hypertrophic scars, and sometimes keloids, but people (even physicians) typically call all of these keloids. There is a difference, but that's beyond the scope of this post. The scars can easily be cosmetically worse than the original mole. Even scar revisions of these scars risk creating a worse situation. If you do have removal of the moles, make sure you follow up with your plastic surgeon or dermatologist frequently, and do exactly what they tell you regarding the management of the scars. You might get away with being noncompliant with scar care on scars on other areas of the body and have a decent result, but not here. Again, if it's just a cosmetic worry, consider leaving the moles alone. And as far as people thinking about piercings in this area, just don't do it.