A common reason we see patients for a consultation at our office in Charlotte is for an evaluation for the treatment of facial keloids. Patients with keloids typically present with a multitude of concerns including:
- Aesthetic concerns
- Continued growth of keloid
- Discomfort including pain and itchiness
There are a wide variety of possible treatment options for keloids. Over the years, I have developed my own treatment guidelines for patients with keloids and our success rate is overwhelmingly high.
What is a Keloid?
When the skin is injured, the body has a normal mechanism to repair the injury. During this process, the immune system will destroy bacteria and the body will create new collagen, scar tissue, and skin. In patients who develop a keloid, this healing process becomes overactive, and the body continues to make scar tissue and skin. The continued growth of scar tissue and skin will create a keloid.
How is a Keloid Treated at Carolina Facial Plastics in Charlotte?
At Carolina Facial Plastics in Charlotte, the most common treatment for a facial keloid is to surgically remove the lesion. Keloids have the tendency to recur or come back after excision. Secondary to this fact, Dr. Kulbersh has developed a process to prevent the recurrence of the keloid. This process entails the following details:
- In excising a keloid, there are special considerations and techniques that Dr. Kulbersh will use. Since keloids are formed secondary to trauma, during the removal, Dr. Kulbersh will not touch or traumatize the normal skin around the keloid.
- Keloids can be stimulated secondary to inflammation. Some sutures can be inflammatory to the skin. The stitches used during a keloid excision are the least irritating types of sutures.
- We believe that the aftercare of the procedure is equally important as the surgery. It is very important to keep the stitches moist and clean as this will promote healing.
- During surgery and after surgery, Dr. Kulbersh will inject the area with a medicine called 5-fluorouracil. 5-fluorouracil is a potent anti-inflammatory and is a key ingredient in preventing the recurrence of the keloid.
What is 5-Fluorouracil?
5-Fluorouracil or 5-FU is a chemotherapy agent. It is used as a treatment for cancer as it kills rapidly growing cells. While a keloid is certainly not cancer, it does share some characteristics. During the formation of a keloid, new scar tissue and skin cells are rapidly growing. Injecting 5-FU during the healing process, after the excision of a keloid, will theoretically kill any cells that are attempting to form a keloid. 5-FU is injected at the following times after a keloid excision:
- During surgery
- 2 weeks after surgery
- 4 weeks after surgery
- 6 weeks after surgery
- 4 months after surgery
- 7 months after surgery
- 1 year after surgery
Since Dr. Kulbersh has been using this algorithm for the treatment of facial keloids, his success rates at preventing the re-formation of a keloid is overwhelmingly high.
What are the Details of the Surgery to Remove a Facial Keloid?
The overwhelming majority of facial keloids can be removed during a straightforward in-office surgical procedure. During this procedure, Dr. Kulbersh will draw around the keloid to show the patient exactly where the incisions will be made. Next, the keloid will be injected with numbing medicine. This injection will take less than two minutes. After the area is numbed, the area will be cleaned, and the surgery will begin. During the procedure, the patient will feel no discomfort or pain. Typically, the surgery will last between 30 and 90 minutes. The procedure is well-tolerated by patients.
What is Recovery After the Excision of a Facial Keloid(s) Like?
Stitches will remain in the surgical area for one week. During this week of recovery, patients are encouraged to take it easy and limit their physical activity. The stitches need to be kept dry for 48 hours. After this time, patients can get the area wet in the shower. There is little pain or discomfort after the surgery. Most patients will take the day of surgery off from work and return to work the next day. Generally speaking, the recovery process is rather uneventful.
What are Common Areas for Facial Keloids?
While facial keloids can form on any area of the face, the most common areas are on the ears and in the scalp.
Are All Patients Good Candidates for Surgical Excision of Facial Keloids?
In my experience, most patients are good candidates for surgical excision of facial keloids with injections of 5-FU after surgery. There are patients that have excessively large or wide keloids that would not be good surgical candidates. During a consultation, Dr. Kulbersh will explain if you are or are not a good candidate for a surgical excision of the facial keloid.
How do I Schedule a Consultation to Learn about Keloid Removal in Charlotte?
Dr. Kulbersh is a Beverly Hills, double board-certified, facial plastic surgeon. He commonly and successfully treats facial keloids at his practice in Charlotte, North Carolina. To make a consultation with Dr. Kulbersh, please call (704) 842-3644 or fill out the online consultation form on this website.
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