Managing Keloid Scars After Surgery: Tips for Effective Treatment - Plastic Surgery

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Managing keloid scars, especially after surgery, can be a challenging process, particularly for individuals with a predisposition to keloid formation. Keloids are raised scars that occur due to an overproduction of collagen during the healing process, leading to thick, fibrous tissue that extends beyond the original wound site. Given your history of keloid formation and the upcoming surgery to remove the steel plate from your arm, it’s essential to approach this situation with care to minimize the risk of exacerbating the keloid.

Firstly, it’s crucial to discuss your concerns with your surgeon before the procedure. They can provide insights into the surgical technique that will be used and how it may affect your existing keloid. If the surgeon can perform the removal of the steel plate through the same incision as the original scar, this may help reduce the risk of creating a new scar. However, if the incision needs to be extended or altered significantly, there is a possibility that the keloid could become larger or more pronounced.

Here are some effective strategies for managing and treating keloid scars:
1. Surgical Options: If the keloid is particularly bothersome, surgical excision is one option. However, it’s important to note that excising a keloid can sometimes lead to the formation of a new keloid. Therefore, surgeons often recommend combining excision with other treatments, such as corticosteroid injections, to reduce the likelihood of recurrence.

2. Corticosteroid Injections: These are commonly used to flatten keloids. The injections help reduce inflammation and collagen production. Multiple sessions may be necessary, and the results can vary from person to person.

3. Silicone Gel Sheets or Silicone Gel: Applying silicone gel sheets or silicone gel to the keloid can help flatten and soften the scar over time. These products create a hydrated environment that can improve the appearance of scars.

4. Pressure Therapy: For some patients, wearing pressure garments over the keloid can help flatten it. This method is often used for larger keloids and requires consistent use over several months.

5. Laser Therapy: Laser treatments can help reduce the redness and thickness of keloids. Different types of lasers can be used depending on the characteristics of the keloid.

6. Cryotherapy: This involves freezing the keloid with liquid nitrogen, which can help reduce its size. It is often used in conjunction with other treatments.

7. Radiation Therapy: In some cases, low-dose radiation therapy may be used after surgical excision to prevent keloid recurrence.

8. Topical Treatments: While you mentioned using a scar gel, it’s important to ensure that the product contains effective ingredients. Some gels contain silicone, which is beneficial, while others may have additional components like onion extract (found in products like Mederma) that some people find helpful.

9. Avoiding Irritation: After surgery, it’s important to avoid any irritation to the scar area. This includes avoiding tight clothing, excessive sun exposure, and any activities that could cause friction on the scar.

10. Regular Follow-Up: Regular follow-up with your healthcare provider is essential to monitor the scar’s progress and make adjustments to your treatment plan as necessary.

In conclusion, managing keloid scars after surgery requires a multifaceted approach. It’s vital to communicate openly with your surgeon about your concerns and treatment options. By combining surgical techniques with adjunct therapies, you can improve the chances of minimizing the appearance of your keloid scar. Always remember that individual responses to treatments can vary, so patience and persistence are key in achieving the best possible outcome.