Whenever an incision is made on the body a scar is formed. Scars are a part of the normal healing process of the body, though this process sometimes creates an unattractive and deformed mark on the skin. People tend to think of all scars as “bad.” Thousands of people undergo incisions during surgery each day, but people only see and hear about the scars that look bad.
There are certain factors that may predispose an incision to create a bad scar. Areas that are subject to repetitive motion, such as the elbows and knees, have a higher rate of bad scarring. This is due to recurring movement of those specific body parts, which can cause scars to widen. Additionally, some people are predisposed to have abnormal scarring, and they form either hypertrophic scars or keloids.
What is a hypertrophic scar?
A hypertrophic scar is the result of a vigorous healing process. The body’s cells are producing too much scar tissue, which causes the scar to raise from the skin.
A hypertrophic scar is seen raised from the skin.
What is a Keloid?
A keloid is the result of an abnormal healing process in an incision or cut. Cells in the scar continue to make scar tissue after the healing process should be completed. This creates raised and large scars that are larger than the initial incision or injury. Keloids have a 5%-16% greater incidence in African American and Hispanic patients.
A keloid is seen as a wide and raised sightly scar following healing from the injury.
What is the rate of abnormal scarring on the face?
Facial plastic surgeons and head and neck surgeons rarely see hypertrophic scars or keloids on the face. The skin on the face is highly vascular (full of blood) and relatively immobile, both unique qualities of the face that prevent the formation of these types of scars. The exact mechanism is not fully understood.
A new study shows that the rate of facial keloid formation after surgery on African American patients is 0.8%, and 0.1% in Caucasians. Although the title of the study truly states that African Americans are seven times more likely to form keloids, this statistic is a little misleading. The study leads us to believe that African Americans are commonly forming bad scars on the face, which is simply not true. I consider 0.8% a low rate. Keloid formation is always a concern in my African American and Hispanic patients who request facial plastic surgery in Charlotte. As proven in this study, I can confidently say the risk of keloid formation is low, but real, for any patient in Charlotte undergoing a rhinoplasty, facelift, eye lift, or other surgical procedure on the face.
What are the treatments for hypertrophic scars and keloids in Charlotte?
There are many options for treatment. Generally, keloids are more difficult to treat and have a higher return rate. A combination of treatments including injections, silicone, pressure, surgery, and even radiation therapy can be used to treat these conditions. I welcome any patient in Charlotte with a keloid or hypertrophic scar to consult with me and discuss your options.