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In earlier blog postings, Keloids of the Earlobe: Treatment and Issues Regarding Recurrence  and Recommendations For Effective Treatment of Keloids, I emphasized several important issues associated with keloids that MUST be addressed in order to have the best prospects for a cure and also to avoid the largely preventable situation of their evolving into  colossal, deforming and symptomatic growths that dwarf their initial size. These included:

a)    keloids have a high rate of recurrence which doesn’t necessarily occur immediately after treatment
b)    the importance of their complete treatment which most often involves a combination of surgical excision and steroid injections with subsequent postoperative injections if clinically warranted; application of silicone gel and/or silicone gel sheeting long term where possible
c)     the imperativeness of frequent and close long term follow up after their treatment to monitor for recurrence of the keloid
d)     the not infrequent and often avoidable disastrous consequences of not having this type of follow-up.

I have had countless patients consult with me regarding treatment for their massively sized, problematic, deforming and recurrent keloids that had been previously “treated” by one or more physicians. Unfortunately, their prior treatments were incomplete or inadequate and there was little or no treatment or follow-up afterwards. Time passed by, the keloids continued to grow and for many reasons, the patient didn’t seek a re-evaluation from a plastic surgeon until the size of the keloids far dwarfed their initial size.

The following patient of mine dramatically illustrates the potential magnitude of the problem created when these tenets are not followed:

This 39 year old male developed a few very small keloids on his face around 5 years ago. These were surgically treated by two different surgeons involving three distinct operations over a period of time. He had virtually no follow-up after each of these procedures and he did not receive repeated steroid injections or have any other intervention. Each time that he sought treatment for a recurrence, the keloids were significantly larger than they had been previously.

He came to my office for his consultation with his face and neck tightly wrapped up with a scarf like garment (in over 100 degree weather) to cover-up his overwhelmingly sized, severely deforming, symptomatic keloid (see photos).

Recurrent facial keloid

Massive recurrent facial keloid

Recurrent facial keloid – right side

Massive recurrent facial keloid - left side

Recurrent facial keloid – left side

What started out as a few small lesions has devolved into an out of control, life altering, debilitating, massive and symptomatic deformity and growth which will require extraordinarily complex procedures that under the best of circumstances will still leave him with considerable problems. This situation could have been doubtlessly averted if only the proper treatments were instituted.

So, if you have a keloid and are seeking treatment, make sure that not only is the treatment adequate, but that you have the appropriate postoperative follow-up including judicious usage of steroid injections as warranted. Typically, I will follow-up my patients for around a year and a half as this is the period during which virtually all keloids would recur.

Take this seriously. If you blow off any needed follow-up for whatever reason or if you experience a recurrence but do nothing about it immediately – you are setting yourself up for major problems, deformities, inconveniences and otherwise unnecessary costs.

For more information on the treatment of keloids, scars or any other plastic surgery procedure that I perform, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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A Message Regarding Coronavirus/COVID-19

In light of the coronavirus/COVID-19 pandemic, we would like to let you know of some of the major precautions we are taking in our office to maximize cleanliness and keep the environment as sanitary and safe as possible. Our highest priority is always to ensure the safety of every individual who sees us and we are taking extreme infection-control measures to maintain cleanliness and “sterility” of surfaces and the overall environment.

We will be limiting dates and times for office appointments and consultations due to safety and other issues. Consequently, if you have already made an office appointment or consultation prior to March 18, 2020 to occur at a later time, this may need to be changed.

For anyone considering plastic surgery, we are now offering Virtual Consultations and Telemedicine through Skype. A great number of aesthetic or insurance-related issues can be evaluated via pictures and online video conferencing, making this an excellent way to find out more about particular procedures, determine candidacy for treatment, receive answers to questions and facilitate being able to move forward with care once the government lifts all restrictions.

In an abundance of caution, we are asking all current patients who are experiencing a fever, cough, chills, fatigue or any type of respiratory illness to please delay any upcoming appointments at our practice. We can talk with you by phone or email to establish a new date and time for the appointment.

We are all in this together. Our team urges everyone to follow the guidelines recommended by local health authorities and the Centers for Disease Control and Prevention, which include frequent handwashing for a minimum of 20 seconds, social distancing, staying home if you are feeling sick, and contacting your healthcare provider if you feel you are experiencing symptoms.

For more information, please read our blog – Coronavirus and You: Important Information

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If you have any questions or concerns, please contact us by phone or email.