What should I do for a stubborn facelift keloid scar?

i would have to say this is rare

certainly unfortunate

and challenging

hypertrophic scars are more common

please give us follow up when you finish your treatment and let useknow what your doc thought it was (keloid v hypertrophic scars) and what he suggested

Thank you for your question.  True keloids are rare in the face in caucasians but I have seen one in a type 1 skin (she was fair, red hair, with freckles, East European).  More other facial keloids were in darker skin patients (Fitzpatrick Skin types 4, 5 and 6). You have done all things that can be done with true keloids: silicone pressure, intralesional steroids, radiation, etc.  My most difficult ones did respond to re-excision and immediate radiation treatment (type 6 skin, skin lesion excision, cheek).  Radiation treatment requires a discussion with the radiation doctor to evaluate the pros and cons of radiation.  The other possibility is undue tension at the closure and perhaps some excessive inflammatory response to some stitches.  Those normally leads to scars called hypertrophic scar, and the treatment would be no-tension closure, wide undermining and perhaps trying a different types of internal stitching and to keep those to a minimum.  Best of luck!  Dr. Marc DuPere, Board-Certified Toronto Plastic Surgeon