Successful Neck Lift Results for Keloid Prone Skin?

Question

Can a person with keloid prone skin/scar tendencies have a successful neck lift? I am a 56-year-old female and am developing a turkey neck, but am concerned about surgery due to my skin type. Are there new procedures for my type of skin? Thank you.

Philip S. Schoenfeld, MD, FACS · Answer

The deformity of your neck that you  have described is a common one.  The "Turkey Gobbler" deformity of your neck is caused by a combination of skin laxity, submental fat, and laxity of the muscles of the neck (platysma).  In someone who is not prone to keloid formation, there are several options for a neck lift procedure.  In someone who is prone to keloid formation, generally darker pigmented skin, the incisions need to be hidden or kept quite small in order to hide any potential scars.  Your surgeon and you will discuss your particular problem and it may be that you will have to trade a perfect result for a good result in order to minimize the potential for unfavorable scarring.  I feel, however, that when placed in the appropriate positions, the scarring should be minimal even in Keloid formers during a neck lift procedure.

Raffy Karamanoukian, MD, FACS · Answer

Ultherapy may be an excellent option for a revision neck lift or a primary neck lift in patients who are prone to keloids. Raffy Karamanoukian MD FACS

Tanveer Janjua, MD · Answer

The risks of forming keloids after a neck lift outweigh the advantages and benefits of a neck lift. It is better to just do a neck liposuction to remove the fat and later do skin tightening with a laser.
Regards

Ron Shelton, MD · Answer

Depending on what is contributing to your turkey neck, Botox might improve a tightening of the platysma muscle bands, Thermage may help tighten the skin and muscle component, although you won't get the same great result of reshaping compared with a neck lift, and liposuction can be done to remove fat but the insertion sites of the liposuction could become keloids too. If you do have a treatment, and start to notice thick, tender or painful scars, do not delay a followup appointment with your surgeon as there can be better improvement of hypertrophic scars and keloids if they are treated at an earlier stage. Be careful and see a board certified plastic surgeon to evaluate your neck lift.

Otto Joseph Placik, MD · Answer

Despite the best of skills, Keloids can develop and there is no definitive way to prevent their development. We tend to use techniques that minimize trauma, but keloids are unpredicitable and at times unavoidable.

Brent Moelleken, MD · Answer

More than with any other patient, the keloid patient demands a meticulous, talented surgeon.  Skillful concealment of incisions, atraumatic technique, and many thousands of cases of experience are necessary.
There is a decision making tree that experienced surgeons use to assess the risk of keloid formation given the patient's background, existing scars, and desired surgery.  Sometimes, the surgery should be done in stages to assess the areas for healing.  In every case, close attention must be paid to the incisions after surgery.  It is a long term relationship the doctor and patient must form.
A clumsily done minilift closed under great tension will produce the worst results in patients with a tendency to form keloids.
However many patients are under the false impression that they are "keloid formers" because they developed a bad scar on their chest or shoulder.  This may not necessarily mean that the face will not heal well, or that the patient has any propensity at all for keloids in the face.
Your board certified plastic surgeon can help you make decisions based on the above factors and other factors as well.

D.J. Verret, MD · Answer

Having any kind of surgery when prone to keloids runs the risk of keloid formation. Fortunately with careful operative technique and close postoperative follow up, you can minimize your risk. I would also suggest a test spot behind the ear before undergoing surgery to see how keloid prone you might be.

Steven Wallach, MD · Answer

If you are a true keloid former I would avoid a neck lift because the scars will form keloids. If you hypertrophy that is different.

William Portuese, MD · Answer

Yes, a keloid-prone skin can have a successful neck lift or face/neck lift. Close postoperative evaluation by your surgeon injecting cortisone shots into the incision can be done early on to prevent keloid occurrence. There are no guarantees that a keloid will not develop.

H. Michael Roark, MD (retired) · Answer

Many patients with keloid scars can have face and neck scars made that heal well. The secret of keloids is to prevent them. High tension on the skin closure is the problem. Specialized techniques for repair on deep structures with gentle redraping of skin uniformially gives inproved results.

Successful Neck Lift Results for Keloid Prone Skin?

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