Kelloids

[Jopet]

How to avoid the possible occurence of Kelloids during the healing process?

[radio]

Look into this:
http://www.biodermis.com/

I'm one week post-op, and am planning to order some of these in the mail shortly:
http://www.biodermis.com/scar_products/epi-derm

It's a big sheet, so I plan to cut smaller squares/rectangles from the main sheet to use over my areolas. I'll try to keep you updated on how it works. Realistically, however, I'll never truly know how well they work since I have no baseline to compare it to. Because I won't only apply it to one nipple (comparing it to the non-applied side), I'll never actually know if they helped my recovery. However, silicon gel sheets have proven to improve scar healing.

[Dr. Elliot Jacobs]

A true keloid is very uncommon after surgery.  On occasion, there can be a hypertrophic (thickened or slightly raised) scar.

My treatment usually begins prior to surgery, when I question the patient whether they have had problems with scars from major or even minor skin trauma (ie acne, insect bites, etc). 

There is nothing that a surgeon can do during surgery to prevent a keloid or hypertrophic scar.  (Obviously, I assume delicate tissue handling, accurate suturing of the wound and no infection.)

Once the wound is healed, very careful attention should be directed to it during the first few weeks after surgery.  If there seems to be a propensity towards thickening, then there are a number of skin creams, such as Mederma and ScarGuard, which can help.  Silicone gel sheets can also work, but they tend to be somewhat cumbersome.  Finally, the surgeon can carefully inject some Kenalog or other cortisone into the scar to quiet it down.

The key is jumping on it quickly so that appropriate treatment can be initiated.

Dr Jacobs

[don_joe]

I am keloids prone and the post-op scars are looking beautiful, after 5 months.

[Jopet]

@ don_joe: really? can you post some pics?

@Dr Jacobs: im 1 month post op and I think there's a formation of hypertrophic scar around my areola. Is it OK if I wait for its healing process or apply some creams or gel sheets?

thanks anyway!

[Dr. Elliot Jacobs]

Jopet

I would first check with your surgeon -- sometimes what appears to be a poor scar is just a temporary appearance during the healing process.  You surgeon would know and then advise you.

In the meanwhile, applying vitamin E oil (or in cream form -- OTC from your pharmacy) cannot do any harm and may be of help.


Dr Jacobs

[don_joe]

@ don_joe: really? can you post some pics?

Ok I'll try. I have to specify that my surgeon did NOT cut me open around the aureole.  All I have is 1/4 inches cuts halfway towards my armpit on both sides, and he got everything out through there. It's actually why I selected him. If I was going to have keloids, I did not want them right under my nipple and look like a freak

[Dr. Elliot Jacobs]

Interestingly, there are more problems with hypertrophic scars  (at least in my hands) on the sides of the chest (still a low percentage) than with scars around the areolas, which tend to heal exceedingly well.

Worst case scenario, any hypertrophy of your scar can be easily treated with a judicious and careful injection of kenalog. 

But please wait until/if your surgeon feels it is indicated.  You paid for his/her expertise -- why abandon that same expertise now?

Dr Jacobs