Revise arm lift. Will my keloids come back? (Photo)

Question

Thinking about doing a revision on both of arms. I don’t know why but I have keloids on both my arms . I also had TT but my scars are non noticeable ( NO KELOIDS). Love my Surgen btw he did a great job! ... well as you can see in the photos my Left arm has about is 4 inches long keloids and my right arm about 5 inches long. My question is do you think if I did the revision my keloids will come back??

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding arm lift keloids. From your two pictures, it is difficult to tell if you have arm lift keloids. Keloids by definition is a raised scar that outgrows the boundaries of the original scar. Your scar just looks wide. After the initial surgery, it appears that the arm lift scar widened. However, I do not see any noticeable keloids in your two pictures. Whether you have arm lift keloids or hypertrophic scars, I still would suggest arm lift revision. Typically, arm lift scar revision can be done local anesthesia in the office.  The arm lift scar is locally anesthetized with lidocaine and epinephrine. After you are comfortable, the arm lift scar is excised and the tissue is re-approximated. Bandages are placed. For your arm lift scar revision, you should plan to take off one week from work. It'll be very important for you to minimize any tension on your arms after your arm lift scar revision. It is the tension in the re-approximation that I believe led to the widening of your scars. During your arm lift revision, I would suggest multiple layer closure to include four or five layers of stitching. I would also suggest application of Dermabond to further minimize your arm tension.  Also, I would recommend compression garments for 4 to 6 weeks after your arm lift scar revision. If you have any more questions regarding arm lifts, arm lift hypertrophic scarring, arm lift keloids, please contact my office. Thank you for a great questions regarding arm lift keloids.
  
Sincerely,
  
Dr. Katzen

Kenneth Hughes, MD · Answer

It is important to distinguish among a poor scar, a hypertrophic scar, and keloid scar. If you are a true keloid former, you will have a greater propensity to form keloids with a revision.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Tim Sayed, MD, MBA, FACS · Answer

Your scars may not be true keloids but it is hard to tell from photos alone. Brachioplasty surgery sometimes results in widened scars but if there is some laxity to the skin around the scar, it may be possible to revise it into a thin line again. Be aware, though, that anyone prone to keloids/hypertrophic scarring might have the issue recur even after an excellent scar revision. The arm healing is different from a tummy tuck in terms of the conspicuousness of the scar and the fact that there was tissue removed from a cylinder, which means there may be tension wanting to pull the scar from both directions. Discuss with your surgeon regarding options. Sometimes steroid medication will be injected into the wound edges or radiation may be offered after removing keloids (if it is a true keloid) in order to try to reduce the risk of recurrence.

Revise arm lift. Will my keloids come back? (Photo)

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