Keloid from Facelift?

Hi, hope you're all doing well. I had a facelift 3 years ago and ended up with keloid scars. i tried steroid injections, laser treatments, all the creams prescribed to me and nothing worked. i even had it excised last year and it grew back(along with radiation). Im meeting a plastic surgeon this week, were going to talk about some options maybe excising and prevention(pressure,steroid) Anything specific i should do for a stubborn scar? I cant lift my hair up. 

Doctor Answers 18

Keloid after a facelift

As other surgeons have noted, pictures would be helpful. If the skin was closed under too much tension, a hypertrophic scar can results. A hypertrophic scar is different from a keloid. A hypertrophic scar is thickened scar that stays within the boundaries of the incision line. A keloid actually spreads outside the boundaries of the incision line and often has a mushroom like appearance. I have never had a keloid from a facelift surgery but I have treated keloids in the ear lobe, and traumatic keloids in the neck and face. I excise the keloid and apply a medication known as Mitomycin-C during the surgery. I close the skin under no tension and then perform a series of three Kenalog (steroid) injections following surgery about 2-3 weeks apart. 

Keloids can be very frustrating and you are wise to follow up with a plastic surgeon to evaluate all of your options.

Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

Facelift Keloid and Hypertrophic Scars

Thank you for your question. It does sound as though you have had many of the most advanced treatments for keloid scars.

The newest and in my 31 years of experience, the most successful method for treatment of hypertrophic, raised, red scars after facelift is the 1540 fractional erbium non-ablative laser made by Palomarmedical.

Please see the link below for examples of some of the results obtained with the 1540 Palomar laser.

Keloids After Facelift

A picture would be very helpful.  The reason would be that one could possible distinguish the scar as a keloid or hypertrophic scar.  A keloid is a raised scar that typically does not spread (not wide) vs a hypertrophic scar that is wider than the original incision.  Hypertrophic scars are a result of increased tension on the skin at closure of a facelift.  This may be treated by removal of the area  and closure of the skin without tension.  Sometimes hair may be loss in these areas and hair transplants could help camoflauge the scar.  If this truly a keloid then they are very difficult to treat with a high recurrence rate.  Traditional methods include steroid injection, removal, and silicone sheeting.  Send pictures and/or seek consultations from a couple of BC PS.

Dr. ES

Keloid after Face lift

Thank you for your question about a keloid after a face lift.

  • Keloids are possible but rare after face lift.
  • You may have a 'hypertrophic scar - a thick scar that can form after too much skin is removed. Or a keloid - larger and bigger than the scar itself.
  • You are right to see a plastic surgeon
  • Pressure and steroids can help. Low dose radiation therapy immediately after a keloid is removed can work when standard treatment fails.

Hope this helps!

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Scarring after facelift

Keloid scarring after a facelift is very rare and it sounds like you have tried all the conventional treatments. One must be very cautious with further treatment, as there is a risk of making things worse. If you are having a second attempt at excision, usually we will inject steroids into the wound at the time and then every month for the next 4-6 months to try and prevent recurrence.

Jamil Asaria, MD
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 131 reviews

Rare case that may require lots of preventative attention after excision

Although very rare to result from a facelift, Keloid scarring does sometimes occur in this case.  If you are considering excising again, this time after surgery you may need to commit to a serious regimen of prevention which includes 3-4 times daily massage of the area in question with a cream formulated to prevent and/or restore Keloid scars (there are several available on the market, I have produced my own brand if you are interested in more information).  Please note here that it is not just the cream that is important, its the short massage in conjunction with the cream that will make the difference.

Michael E. Jones, MD
New York Facial Plastic Surgeon
3.5 out of 5 stars 18 reviews

Keloid and facelift

A keloid can be tough to deal with. If you already had scar revision and local radiation there may not be a lot of other options.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Cosmetic Surgery is an Art and a Science.

Thank you for the question. It is hard to answer this without photographs. Patients can get unfavorable scars which are hard to prevent. Keep in touch with your surgeon. You are on the right tract..Dr Thomas Narsete Austin, Tx

Thomas A. Narsete, MD
Denver Plastic Surgeon
5.0 out of 5 stars 10 reviews

Keloids following facelift

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

Adam Bryce Weinfeld, MD
Austin Plastic Surgeon
4.9 out of 5 stars 57 reviews

Keloids after #Facelift

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

Marc DuPéré, MD
Toronto Plastic Surgeon
4.8 out of 5 stars 62 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.