Can keloid scarring be avoided after ear lobe reconstruction?

Question

I currently have my ear stretchered to 3/4, and during the process I tore a few times my ears. While I did manage to tear my ears I never developed any hypertrophic/Kelly's scars. I know I am suseptable to these types of scars because I do have a few keloids. I am looking into ear lobe reconstruction and want to know if this type of scarring can be avoided by using something like silicon gel strips during or after the healing process?

Raffy Karamanoukian, MD, FACS · Answer

Our office repairs earlobes after a traumatic tear of earrings, gauge piercings, or after a facelift in which the earlobes are stretched. Earlobe surgery is composed of several techniques that can either repair torn earlobes (split earlobes) or correct overly redundant earlobe tissue from piercings or genetics or stretching. Our HIDEF earlobe repair includes a recontouring of the earlobe contour using multi-layered sutures to reapproximate the curvature of the earlobe; while simultaneously restoring contour to the ear. In patients with pixie ears after facelift surgery, an alternate technique is used to reduce the dependance of the earlobe on the facelift flap. Facelift surgery can reshape the earlobe and this requires restoration. Sutures are usually taken out within 10 days and the wound is repierced in 4-6 weeks thereafter. Keloid scars must be addressed in patients with known history for scarring.

Keloids are another major reason to undergo earlobe repair if there is a keloid scar nodule that has developed in the earlobe or ear cartilage rim. We use a combination of lasers, injections, and keloid surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Keloids are another major reason to undergo earlobe repair if there is a keloid scar nodule that has developed in the earlobe or ear cartilage rim. We use a combination of lasers, injections, and keloid surgery.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jennifer Lauren Crawford, MD · Answer

If you do have a lot of stretched tissue at the ear lobe, that is a good for avoiding a keloid.  Keloids frequently occur where there is quite a bit of tension on a scar line.  Early scar checks are a good idea as a quick steroid injection may happen early on that could prevent a large keloid from forming.  There are also pressure clips that can be worn and even look like earrings for prevention.  Good luck to you!

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Keloid formation can be treated in the early stages with silicone scar gels, silicone sheets, compression therapy, and cortisone injections.  If you have torn your earlobes in the past and not suffered with the development of a keloid it is unlikely that you will with a reconstruction.  Hope this helps.

Raymond E. Lee, MD · Answer

Thanks for sharing.  Keloids or Hypertrophic scars can occur in the earlobe especially in darker skin individuals. Some people are just more prone to it genetically. Sometimes removing a keloid can actual come back worse.  There are precautions that can be taken to help minimize the chances but there are no guarantees.  Certain sutures can be less reactive and injecting some mild steroid solution at the time of surgery and post operative silicone gel can all be helpful. Discuss with your surgeon and see what the possibilities are for you.

Adam Goodwin, MBBS, FRCS(Plast) · Answer

so the answer is there is no guaranteed way to avoid keloids. If your ears have had multiple traumas already then they arte unlikely but they tend to occur late after injury and can progress indefinitely so even though you don't have any now there is no guarantee you won't get them months or years form now. Sorry for the news but hopefully that helps, Adam Goodwin

Matthew R. Kelleher, MD · Answer

The best way to avoid post
operative keloids is to inject the surgical scar with cortisone. The first
injection should be 3 weeks post-op. This should be continued monthly until
there is no evidence of scar thickening or inflammation. This could be 4-6
months. I regularly excise ear lobe keloids and if this post-op regimen is
adhered to, I have never experienced a keloid recurrence.

Jeremy S. Hurren, BSc, MBBS, FRCS (Plast) · Answer

Silicone gel may help but it if you are going to make a keloid in your ear I doubt that silicone gel is going to prevent it from happening. 
A pressure clip earring can be helpful and I sometimes get these made by the dental prosthetics lab at my hospital. 
I generally would adopt a policy of early steroid injections if the the earlobe shows signs of keloid formation. These frequently need to be repeated.
Best wishes

Sapna A. Patel, MD · Answer

Keloid scars are a tricky process to deal but there are certain things that can be done post-procedure to minimize the chance that you will any keloid scar. Silicone creams/ sheets are a great topical to apply once the incision has healed. Regular kenalog or triamcinolone injections are helps as the steroid can help decrease the chance that this will happen. The other thing is applying pressure to the earlobe- many will buy special earrings online or use magnets (apply one on each side) to provide compression and minimize the chance of a keloid.