Understanding Keloid Excision: What to Expect Before, During, and After Surgery.

Understanding Keloid Excisions: What to Expect Before, During, and After the Procedure

Keloids are raised scars that form due to an overgrowth of scar tissue, often as a result of skin trauma, surgery, burns, or even minor injuries like acne. For some individuals, keloids can be itchy, painful, or aesthetically concerning, prompting them to seek medical solutions. One of the most effective treatments is keloid excision, a surgical procedure that removes the excess scar tissue. You can even view some of recent keloid excisions we've performed here in Bedford, Texas in this keloid excision before and after gallery. This blog provides a detailed guide on what you can expect from keloid excision, from the consultation to recovery and long-term care.

What Are Keloids?

Before diving into the excision process, it’s essential to understand what keloids are and why they form. Keloids occur when the body produces too much collagen during the wound-healing process, resulting in thickened, raised scars that extend beyond the original injury site. Common areas where keloids develop include the chest, shoulders, earlobes, and back.

Keloids vary in size and shape, and while they are benign, they can be emotionally and physically distressing for those who have them. Treatments like keloid excision surgery aim to alleviate discomfort and improve appearance.

Why Consider Keloid Excision?

Keloid excision may be recommended if:

- The keloid causes pain, itchiness, or restricted movement.

- You experience recurrent infections or ulceration in the scar.

- The appearance of the keloid significantly affects your confidence or quality of life.

- Non-surgical treatments, such as corticosteroid injections or silicone sheets, have not been effective or are unlikely to be effective.

- The keloid is in a preferred anatomic location to perform removal, such as an ear lobe, which is the best place for keloid removal.

 The Consultation Process

Before undergoing keloid excision, a thorough consultation with a board-certified dermatologist or surgeon is crucial. During this session:

1. Assessment: Your doctor will examine the keloid’s size, location, and severity to determine if excision is the right approach.

2. Medical History: Be prepared to discuss your history of keloids and any previous treatments.

3. Treatment Plan: Your dermatologist will outline the procedure, potential risks, and post-surgical care plan, which may include additional therapies like steroid injections or radiation to prevent recurrence.

4. Realistic Expectations: Keloids can recur, even after excision, so your doctor will discuss strategies to minimize this risk.

What Happens During Keloid Excision Surgery?

Keloid excision is typically performed as an outpatient procedure under local anesthesia. Here’s a step-by-step overview:  

1. Preparation: The surgical site will be cleaned and marked.  
2. Anesthesia: Local anesthesia is applied to numb the area, ensuring you remain comfortable.  
3. Excision: The surgeon carefully removes the keloid tissue while preserving as much healthy skin as possible.  
4. Closure: The wound would typically be allowed to heal on its own, through a technique called secondary intention. Closure with sutures can complicate keloid excisions and are unlikely to be performed.   
5. Additional Treatment: To prevent recurrence, additional treatments to the wound base with corticosteroid or other therapies absolutely necessary. Corticosteroid injections will be administered directly into the surgical site on the day of the of the procedure and at regular intervals for several months after. In some cases, even low-dose radiation therapy is scheduled shortly after the procedure.

The entire procedure typically lasts between 30 minutes to an hour, depending on the complexity of the keloid.

Post-Surgical Care and Recovery

After keloid excision, proper aftercare is essential to ensure optimal healing and reduce the risk of recurrence. Here’s what to expect:

1. Wound Care:

   - Keep the surgical site clean and dry.

   - Follow your doctor’s instructions for changing bandages and applying any prescribed ointments.

2. Pain Management:

   - Mild discomfort or swelling is normal and can usually be managed with over-the-counter pain relievers like Tylenol.

3. Activity Restrictions:

   - Avoid strenuous activities and heavy lifting that could strain the surgical site.

   - Protect the area from excessive sun exposure, as UV rays can darken scars.

4. Follow-Up Appointments:

   - Attend all scheduled follow-ups to monitor healing and receive any additional treatments, such as corticosteroid injections or silicone sheets.

Minimizing Recurrence After Keloid Excision

One of the challenges with keloid treatment is the risk of recurrence, which can be as high as 50-70% without additional therapies. Your doctor may recommend:  

1. Corticosteroid Injections: Administered at regular intervals to suppress excessive collagen production.  
2. Radiation Therapy: Low-dose radiation may be used post-surgery to reduce keloid regrowth.  
3. Silicone Sheets or Gels: These can be applied daily to flatten and soften the scar.  
4. Pressure Dressings: Particularly useful for keloids on the earlobes, these can help prevent recurrence by applying constant pressure to the area.

Results and Long-Term Outlook

The success of keloid excision depends on several factors, including the keloid’s size, location, and the patient’s adherence to post-surgical care. While complete elimination of the keloid may not always be possible, most patients see significant improvements in appearance and symptoms.

Key Takeaways

- Consultation Is Key: A thorough consultation helps determine the best treatment plan for your unique needs.

- Prevention Post-Surgery: Combining excision with adjunct therapies like steroid injections or radiation significantly reduces recurrence rates.

- Patience Is Essential: Healing takes time, and consistent follow-up care is critical for the best results.

If you’re struggling with keloids and considering excision in the Dallas-Fort Worth area, schedule a consultation with a board-certified dermatologist at Essential Dermatology Group, PLLC. Our team specializes in keloid treatments and can provide a tailored plan to help you achieve smoother, more comfortable skin.