Can Patients with Keloid Scars Undergo Nipple Reduction Surgery?

Can individuals with keloid-prone skin undergo nipple reduction surgery?

Hello doctor, I would like to ask if a person with keloid tendency can undergo nipple reduction surgery.
Additionally, I previously had a fibrocystic tumor excision on the upper part of my breast, and after the wound healed, the keloid appearance is quite unsightly.
Is it possible to surgically remove the keloid scars?

none, 30~39 year old female. Ask Date: 2016/08/25

Dr. Zhou Hongzhang reply Plastic Surgery

1.
Individuals with keloid-prone skin are at risk of developing keloids whenever there is a wound.
It is advisable to avoid surgery to minimize the likelihood of keloid formation.
2.
Surgery can remove keloids, but there is a possibility that keloids may recur at the original site.

Reply Date: 2016/08/25

More Info

When considering nipple reduction surgery for patients with keloid scars, it is essential to understand the implications of keloid formation and the surgical process involved. Keloids are raised scars that occur due to an overproduction of collagen during the healing process. They can develop after any type of skin injury, including surgical incisions. For individuals with a history of keloid formation, the risk of developing new keloids after surgery is significantly higher.

In the case of nipple reduction surgery, the procedure involves making incisions around the nipple area, which can potentially trigger keloid formation in susceptible individuals. Therefore, it is crucial for patients with a known keloid tendency to discuss their concerns with a qualified plastic surgeon or dermatologist who specializes in scar management. The surgeon may recommend various strategies to minimize the risk of keloid formation, such as:
1. Preoperative Assessment: A thorough evaluation of the patient's medical history, including previous keloid formations, is essential. This assessment helps the surgeon understand the patient's risk profile.

2. Surgical Technique: The choice of surgical technique can influence the likelihood of keloid formation. Techniques that minimize tension on the skin and follow natural skin lines may reduce the risk of scarring.

3. Postoperative Care: Proper wound care is critical. Patients may be advised to keep the incision site clean and moisturized. The use of silicone gel sheets or silicone gel can also be beneficial in reducing scar formation.

4. Steroid Injections: In some cases, corticosteroid injections may be administered post-surgery to help prevent keloid formation. These injections can help reduce inflammation and collagen production at the surgical site.

5. Alternative Treatments: If keloids do develop, there are treatment options available, including laser therapy, cryotherapy, and surgical excision. However, these treatments may not guarantee complete removal and can sometimes lead to new keloid formation.

Regarding the removal of existing keloid scars, surgical excision is an option, but it carries the same risk of keloid recurrence. Patients should weigh the benefits and risks with their healthcare provider. In some cases, a combination of surgical excision and postoperative treatments (like steroid injections or radiation therapy) may be recommended to minimize the chance of recurrence.

In summary, while patients with keloid scars can undergo nipple reduction surgery, careful consideration and planning are necessary to mitigate the risk of new keloid formation. Consulting with a specialized surgeon who understands the complexities of keloid management is crucial for achieving the best possible outcomes. Additionally, discussing all available options for both the nipple reduction and the management of existing keloid scars will help patients make informed decisions about their surgical journey.

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