Eyelid Surgery OK if Prone to Keloids?

  ASfter 25 years in practice and thousands and thousands of these procedures, I have never seen keloids develop from eyelid surgery.  Set your mind at rest, the risk is minimal if at all.

A keloid is a histologically different form of tissue than a normal scar, growing beyond the boundaries of the original wound. Keloids form on the deltoid, sternum, and earlobe/auricle regions. Eyelid skin is the thinnest skin in the body and lends itself to excellent scarring in the vast majority of cases. Your chances of being struck by lightning or winning the lottery are greater than forming a keloid on your eyelid after ptosis surgery by a qualified surgeon.

First of all, it is common to call any thick, dark scar a keloid. Keloids however are more specifically a benign tumor of the skin which occurs in response to some injury, accidental or surgical. A scar that is thick, raised and dark is usually not a keloid, but more appropriately called a hypertrophic scar. If what you are calling a "keloid" is in fact not a big tumor-like growth, you probably have a hypertrophic scar, and this rarely occurs on the eyelid. Keloids are also rare on the eyelid too If your ptosis is obscuring your vision, you should probably not worry about the scarring, but should get your lids fixed. Just make sure this is being done by a surgeon certified to do this procedures with alot of experience. Make sure also that this surgeon examines your other scars and answers your questions about the likely appearance of the scar on you eyelids.

True keloids of the eyelid are extremely rare. However, it is worth bringing your concerns to the attention of your surgeon. The surgeon will assess scars on your body and your medical history to determine if you have a true problem with how you heal your scars.
Also I will advise extreme caution in picking a surgeon to address your congenital ptosis in India. You want to find someone who has fellowship training specifically in eyelid plastic surgery or pediatric ophthalmology and a residency training in ophthalmology. They should have a reputation in congenital ptosis surgery.
A general plastic surgeon, general ophthalmologist, or facial plastic surgeon are generally not going to possess the skills to help you. You might look up Miland Naik in Hyderbad, India. If it is too far to see him, his office might have a referral closer to home for you.

Typically, this operation leaves hardly noticeable scars, however if you develop keloids elsewhere then it is theoretically possible to develop them anywhere. Depending on how severe your degree of levator ptosis is you may need to stop and reconsider the operation.
Many times, patients will have their levator ptosis fixed just to get insurance to cover their blepharoplasty. In your case this would be a very bad idea for obvious reasons. If your levator descent is such that you are having difficulty seeing and there is a clear medical indication for it then there comes a point where you and your plastic surgeon will have to consider playing the odds. Many patients think they have a keloid and it's a hypertrophic scar so that also needs to be looked at. Unfortunately, you are an interesting case.
Best Wishes.

Keloids scars are very unusual on the eyelids and most patients that have been told they have "keloids" don't actually have keloid scars, but rather hypertrophic scar potential or traumatic scar.

Keloids are rare in the eyelid. I often make a very minimal incision through the inside of the lower lid so the incision cannot be seen, is very small and doesn’t scar. Therefore it should not be a problem for those that are prone to keloids.

We have never seen a keloid on the eyelids and it would be extremely rare to develop a keloid on the eyelid. If there is only a ptosis repair that needs to be performed, this could be potentially performed from the inside of the upper eyelid.

As an oculoplastic surgeon, I have never seen a keloid scar in the eyelid. While this is certainly no guarantee, discuss this with your surgeon. The advantage of repairing the congenital ptosis outweighs any potential risk for scar formation in my book.

If this were an elective procedure for cosmetic reasons, you would probably be better off not tempting fate so to speak. Usually keloids do not form around the eye. However for ptosis, You may want to consider the chances and just be monitored very closely for keloid development.