Facelift for Patient Prone to Keloids?

The good news is that facial skin is less prone to keloids that skin on other areas of the body. The other good news is that eye surgery rarely results in keloids. The bad news is that keloid and other hypertrophic scars can be a result of poorly performed facelifts and are especially common in “lite” lifts that create a great deal of tension on the sutures.

The best news is that if you take the time to find a facial plastic surgeon who has expertise and finesse, you should not have a problem with scarring. You do not mention whether your skin is dark or light. If you do have darker skin, it will be more prone to scarring and in that case it's essential that your facial plastic surgeon has a great deal of experience performing facelifts on ethnic skin. I hope this helps.

Keloids occasionally appear in facelifts, and rarely in eyelid surgery.  It really depends on what other scars on your body look like and whether they are truly keloids.  Fortunately, the face heals so much nicer than skin on other parts of the body and keloids are rarely a problem.

Keloids and hypertrophic scars ( a similar but distinct raised scar) can occur in some patients after a facelift.  It is not possible to predict which patients will develop a keloid or raised scar after the procedure.  Surgeons should avoid tension on the skin, meticulous close the incisions, and have long term follow up with the patients to ensure scar formation is minimized.  

In patients with a higher likelihood of keloids, consideration can be made to a limited incision lift versus an alternative to a facelift. 

These procedures have a low rate of hypertrophic or keloid scar occurence, in my opinion.  Treatment should focus on minimizing tension and proper wound healing postoperatively.  I would recommend surgery. 

I would approach the facelift cautiously in a patient prone to keloids.  Deciding whether to perform the surgery or not.  If the patient understands the downside of the cosmetic result then facelift may be done and steroid injections and/or silicone sheeting performed to minimize keloid formation.

Concerning the eyelids, keloids rarely if ever form from an incision in the delicate eyelid skin.

Dr. ES

Far and away the best way to prevent keloids is meticulous, expert technique. Not too much tension on the closure, clever suturing.
Minilifts are notorious for producing keloid scars. There is simply too much tension placed on the incisions and they stretch out, causing bad scarring.
Facelift surgery is definitely an artform as well as a surgical procedure.
That being said, different skin types scar differently. There are special measures that need to be taken with patients with black skin, Asian skin, etc. to prevent keloid formation above and beyond excellent surgical technique.

 In 30 years I have never seen keloids of the eyes or facelift. I have seen wide scars due to too much tension on the skin. Going to an experienced facelift surgeon should give you what you want without keloids.

Indeed you can have a facelift if prone to keloids, however, both the patient and the surgeon must understand that there is a very small risk that you can get a keloid from a facelift. Only dark-skinned and Asian patients are susceptible to this. It is important that cortisone shots are placed in the incisions at the time of the surgery and very close following and monitoring postoperatively for occurrence of these keloids can be done. Sequential injections of steroids at a month and three months along the incision site will help prevent them from occurring.

I would agree with most of the comments. Keloid type scarring is possible but usually does not occur even with a history of keloids elsewhere on the body. Exacting surgical technique is extremely important. Unfortunately, no one could give you a 100% guarantee that a keloid would not occur. It may be worthwhile doing a small facial procedure at first just to see how you feel.

Eyelids rarely if ever keloid. However, if you are a true keloid former, not just hypertrophic scars, facelift that use incisions around the ears can have problematic scars. Even in non-keloid patients, hypertrophic scars can appear around the ears or back of the neck. Discuss the relative risks carefully with your surgeon. Perhaps there are other methods to get you close to what you want without undue risk of unsightly keloids.