If a Person Who is Prone to Keloids Wants Plastic Surgery, What Steps Can They Person to Take Reduce the Risk of Scarring?

I would treat the scar afterwards with Plato's Scar Serum, laser therapy, and Kenalog IIT to prevent scarring. Best,Dr. Karamanoukian#Realself100 Surgeon

If you are a true keloid former then you are certainly likely to develop this type of abnormal scarring with any incision.  True keloid former will make a bad scar even from stretch marks.  While you are correct that there are treatment options available they do not always control keloid scarring.  The real question is if you have developed keloid scars in the past or have a strong family history of keloid scarring. 

If you form keloids on other areas of the body, then I would caution you to not go ahead with other elective breast surgery to avoid keloids from occurring.    An incision will always produce a scar.

If you have a strong history of recurrent keloid formation having low dose radiation immediately after your procedure for 3 to 5 days will reduce your recurrence rate to a 2% chance. Even if it does recur, the recurrence will likely be smaller and can be managed most of the time with kenalog injections if you do regular followup. If you do not have a strong history of recurrent keloids, and you just "think you might be prone", I would not recommend the radiation at the first procedure and would treat the wound with continuous topical silicone after surgery. If you do keloid, then they can be excised and the area radiated. Most of the time keloids to not occur in the entire incision so it is best to wait and see where they might occur if at all. Also be sure you know what a keloid really is because I have had many patients say that they are "prone to keloids" and then I find they are calling just a hypertrophic scar a "keloid". The definition of a keloid is an over grown scar that grows outside the original wound edges.

Thank you for your question. It is widely accepted that the use of staged low dose radiation treatments within 24 hours of surgery will cut down on the chances of the keloids forming post operatively.  This being said, it has been my experience that patients most often associate this with the formation of cancer and apprehension is quite common. Kenalog (steroid) injections are also another course of treatment to aid in the prevention of keloid scarring. In speaking with a plastic surgeon I would definitely express all your concerns regarding treatments and see exactly what he/she would recommend. Make sure that you see a board certified plastic surgeon who has experience with the treatment of keloid formation. I hope this helps you and good luck! Fadi Chahin MD, FACS Plastic and Reconstructive Surgery, Diplomat American Board of Surgery, Diplomat American Board of Plastic Surgery