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Key Points:
- Keloids are different from hypertrophic scars. They are histologically (under a microscope) different and must be treated accordingly. Simple surgical removal will oftentimes lead to a much worse result afterward. Dr. Lam has found that even removal followed by steroid injections fail in almost every case. Through years of experience he has developed the best surgical technique to remove keloids and has worked with expert radiation oncologists to provide the best outcomes for his patients.
- Dr. Lam does not accept insurance for his keloid surgery. However, he does advise you to use your insurance to cover your radiation treatment.
- Typically, most keloid excisions are performed under local anesthesia so that you can drive to Dr. Lam’s office for the procedure and then immediately thereafter drive to the radiation treatment. Radiation typically takes several days to complete. Since the timing is important, for out-of-town keloid patients, it is important to have both the surgery and the radiation performed in Dallas.
Frequently Asked Questions about Keloid Removal
What is the success rate that Dr. Lam has observed with keloids?
He has enjoyed a success rate of over 90% for eradication of one’s keloid. He defines success as a keloid not returning for over a year. After that time, it is very unlikely that a keloid will come back. He has had a very high success rate in his keloid excisions despite working mainly in individuals who have failed multiple treatments elsewhere.
Does Dr. Lam perform Cryoshape for keloids?
At one point, he did use Cryoshape (a freezing method) for keloids but did not achieve uniform success. In addition, patients experienced a very long recovery time of several weeks before the keloid involuted, or shrank, compared to the almost immediate result of surgery. In short, he did not find this method to be very successful for his patients.
What if after Dr. Lam’s treatment the keloid returns?
In the rare case that a keloid does return, Dr. Lam offers a significant discount for secondary surgery. However, you must still cover the radiation costs if your insurance does not. Unlike in cancer treatments, radiation is safe to be performed again in a patient with a keloid because it is very low dose. Dr. Lam advises to use pressure earrings for those who have earlobe keloids in addition to surgery and radiation to minimize recurrence. (You can Google search “ear lums” for small areas like the earlobes or “McKesson ear pressure device” for larger ear keloids.) In addition, if you experience an early recurrence of a keloid, it would be very advisable to seek a local dermatologist to inject the keloid. Dr. Lam partners with a few dermatologists who use advanced immunotherapy to manage small, early keloids. Catching a recurrence early can save the expense and the recovery of undergoing another surgery.
Is radiation safe?
Radiation has been theoretically associated very very rarely with skin cancer in the treated area. However, it is always advisable when you speak with the radiation oncologist to ask more specifics about this risk so that you have informed consent about it. Dr. Lam believes that the benefit of a definitive keloid excision is worth the very small risk of a skin cancer from the radiation treatment.
Are there alternatives to surgery and radiation for my keloid?
Dr. Lam believes currently the answer is no. However, there is ongoing research on keloids that may make it a non-surgical correction. Dr. Lam injects and uses lasers on hypertrophic scars, which, as mentioned, are entirely different from keloids and should not be confused with them.
Your Cosmetic Surgery Procedures will be performed by Dr. Lam's surgery center located in Dallas, Frisco and Plano, TX.
Dr. Lam explained the procedure of my Keloid Excision on my left earlobe. He was patient and answered all my questions. The procedure went smoothly. I did the radiation right after the procedure. It’s been seven months and I see no sign of my Keloid returning. There is a fine line on my earlobe where my Keloid used to be which is nothing compared to the scar that was there before. Dr. Samuel Lam will continue with the follow ups.
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