Will Juvederm Cause Scars on Keloid-prone Skin?

Question

I want to get Juvederm for under eye puffiness, and nasolabial folds. My only concern is that I have keloid prone skin. Will the injections leave tiny scars throughout my face?

Raffy Karamanoukian, MD, FACS · Answer

Keloid scars are caused by a proliferative deposition of collagen into a wound that may or may not plateau. The incipient cause by as simple as a scratch on the skin to a more invasive surgical scar. Keloids commonly occur from ear piercing, which is analagous to needle injections during Juvederm treatment.
I would not advocate any elective procedure that involves injection, surgical incision, or surgical excision for patients with keloid scars unless absolutely necessary.

Ron Shelton, MD · Answer

Many patients who have keloids are able to have fillers, including Juvederm without keloids developing at the insertion site of the needle or the area in which the filler resides. No one can guarantee that you won’t develop a keloid from the Juvederm, provided that it is inserted with a small needle and good technique without any additional surgical procedure being done at the same time (such as subcision which is a procedure that entails breaking up the collagen below the are to be filled by using a needle tip).

Michael A. Persky, MD · Answer

Hi Fernanda,
Even in patients who are known to keloid, it is extremely rare to form keloids on the face (other than the ear).  I have not seen or heard of a patient who developed keloids after facial injection of fillers.  Discuss your concerns thoroughly with your physician prior to your treatment.  Good luck and be well.
Dr. P

David Shafer, MD, FACS · Answer

Fernanda83,
Keloids are very unpredictable and any trauma to the skin can potentially lead to keloid formation.  The best predictor is previous keloids.  With facial injections, one step that can be used is to perform the injections from inside the mouth.  With this method, there is no external skin puncture and this may reduce the incidence of keloid formation.  Good luck.

Steven Wallach, MD · Answer

It is unlikely to develop keloids from small needle injections, however, any skin trauma may induce keloid formation, so I would be hesitant to do so.

Bryan K. Chen, MD · Answer

I agree that the risk of keloid development from filler injections even in keloid-prone skin is very low, but ultimately you would need to decide if it is worth the risk. Injections done through the inside of the mouth can give equally nice results. You may need to do a bit of searching for an injector experienced with this technique.
Good luck.

Kenneth R. Francis, MD, FACS · Answer

Fernanda,
Although keloids are less common around the eye area, they have a mind of their own, so to speak. Any trauma to the skin can incite a keloid scar to form. Consider injecting through the mouth into your eyelid area, but know that the mouth is a dirty environment and the material can theoretically, at least, get infected. The nasolabial fold injections are done within the skin layers and cannot effectively be administered through the mouth.  Good luck!

Richard P. Rand, MD, FACS (retired) · Answer

The central "T" of the face including the eyes and nose is for some unknown reason generally protected from keloid formation. This plus the fact that Juvederm is injected through a very tiny needle should make this a safe process. Unfortunately, the only way to be absolutely safe is to not do it through the skin. Make sure if you proceed that your injector has experience with going through the mouth.

George J. Beraka, MD (retired) · Answer

To Fernanda83,
Hi!  Fillers are injected with a tiny needle which makes a tiny (invisible) wound.  Theoretically, any punture wound can become a keloid.  But I have not seen this, and we treat dark skinned people, and people who have keloids on their body (for example, C section scar).   So although there are no guarantees, I would say your risk is very low.
By the way, you should not use Juvederm in the undereyes.  Restylane is safer and more forgiving there. For the nasolabial folds, I use Restylane if they are superficial, and Juvederm if they are deeper.  Mostly Juvederm.

Will Juvederm Cause Scars on Keloid-prone Skin?

Answers (9)

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