Keloid scars are abnormal scars that develop after an injury. These scars are wider than the extent of the original injury and often recur after removal. They are raised and reddish and are often unsightly to look at, which can create a feeling of embarrassment and self-consciousness.
Hypertrophic scars are similar to keloid scars in the sense that they are abnormal reddish growths that are itchy. However, these scars stay within the boundary of the initial injury and may spontaneously reduce in appearance. Hypertrophic scars are common after thermal injuries.
Both types of scars are forms of the normal healing process but have grown to be abnormal. During the healing of a wound, anabolic and catabolic processes take place to help with the formation of new skin. When these processes are thrown off balance, they will lead to excessive scarring. Unlike normal scars that are pale and fade over time, keloid and hypertrophic scars last for long periods of time and depending on their location might be prominently visible.
Either of these scars can develop after any kind of surgery, and both are equally prevalent among men and women. People in their 30s and those of African descent have been observed to be more susceptible to the condition. Family history is also a high predictor for these scars. The main cause of hypertrophic scars is high tension during incision closure after any surgery. Keloid scars are the result of excessive collagen fibers in the region during healing.
Keloids and Hypertrophic Scars During Plastic Surgery
Cosmetic surgeries like tummy tucks and breast lifts have a chance of developing excessive scarring. However, hypertrophic scars are avoidable when proper surgical methods are used. Keloids are more dependent on family history and other external factors and thus cannot be completely avoided.
When plastic surgeons close wounds, there is bound to be tension from either side of the incision. To prevent this tension from becoming an issue, surgeons often use sutures on the deeper layers of the skin as well. This keeps the tension in check and leads to the least amount of tension. Most plastic surgeons ask patients to wear compression garments for at least two weeks after major procedures; this improves vascularity and prevents the development of hypertrophic scars.
Treatment of Keloid Scars and Hypertrophic Scars
Compression therapy is the most common form of treatment for both types of scars. Massage is another effective non-surgical option. Hypertrophic scars are more likely to be cured by conservative treatments such as steroid injections, silicone gel, laser therapy, and skin products like hydrocortisone cream. They can also be completely cured through surgical scar excision.
Keloids have a 50% recurrence rate after removal. Corticosteroid injections, when used in conjunction with general keloid-removal procedures, are the least likely to cause recurrence. Keloids typically have to be surgically removed, as conservative methods do not work on them.
Contact Us for a Consultation
Meeting with Dr. Raymond Lee during a consultation is an excellent way to find out more about keloid and hypertrophic scars. Dr. Lee is double-board-certified in Facial Plastic and Reconstructive Surgery and Otolaryngology and will be happy to recommend treatment methods for scar revision. To schedule your consultation, contact our office.
