Comparing Laser Removal and Traditional Surgery for Keloid Treatment

Posted by The Keloid Plastic Surgery Center

Laser therapy and traditional surgery have both been shown to be successful treatment options for keloid scar removal.

Keloids are a type of scar that can be difficult to treat. People often wonder whether traditional surgery or laser removal is a more effective treatment option. With so much information available, it is important to seek expert advice for individuals seeking relief from these unwanted and potentially uncomfortable growths.

Our expert plastic surgeons provide exceptional expertise in surgical excision for effective removal. We aim to offer unbiased information to patients, allowing them to make well-informed decisions based on reliable knowledge and the latest advancements in treatment.

Efficacy in Keloid Reduction

Traditional surgery for keloid reduction can sometimes have a recurrence rate. To improve results, combining surgery with treatments like intralesional corticosteroid injections, superficial radiation therapy, and particularly silicone gel sheeting can help. Using these methods together with surgical removal leads to a lower chance of keloids returning.

Laser treatment is another method offering a less invasive option. It uses light beams to target keloid tissue, reducing its size and appearance. A retrospective study has shown that patients often experience up to a 70% improvement in their keloids after laser therapy. Success rates can be even better when laser treatment is combined with other methods such as steroid injections.

The success of keloid reduction depends on several factors:

  • Keloid size and location
  • The patient’s skin type
  • The aftercare steps followed

Risk of Recurrence After Treatment

Keloid recurrence after treatment is a concern for many patients. Following surgery, recurrence rates can be quite high, ranging from 45-100%. Various factors affect the chance of keloids returning, such as the keloid’s location, the individual’s history, and the thoroughness of the surgical procedure. Despite careful techniques, surgery alone may not prevent reoccurrence.

Laser treatments offer a different approach and success varies depending on certain factors. Although lasers can lessen keloid visibility and discomfort, they don’t fully remove the risk of recurring issues. The size and maturity of the keloid, and the type of laser employed are influential factors. 

Each treatment option should be weighed against the potential recurrence of keloids and the various influencing factors to determine the best course of action.

Procedure Time and Complexity

Excision of a keloid involves removing the scar tissue and closing the surgical wounds with sutures. This surgery can take from 30 minutes to an hour, depending on the scar’s size and location. After surgery, we may use methods like applying pressure or silicone sheets to help prevent the keloid from returning.

Laser treatment is a non-invasive option for keloids, with the complexity linked to the scar’s specific features. This method requires several sessions, lasting between 15 to 30 minutes each. The ablative laser aims to flatten the keloid and lessen redness, and treatments are spaced out over weeks. The total duration for optimal results can take several months.

Side Effects and Complications

Surgical removal of keloids can have some risks. Although we take care to avoid problems, patients should know the possible adverse effects. Keloid recurrence after surgical excision is a common issue and can result in larger keloids. Moreover, infection, blood or fluid accumulation under the skin, and changes in skin color or texture may occur after this treatment of keloids. 

Laser treatment for keloids has a different set of adverse effects. Patients might experience:

  • Changes in skin color
  • Pain during the procedure
  • Swelling and redness
  • Less commonly, blistering, crusting, or a feeling of warmth

To improve healing and reduce adverse effects, we often suggest using silicone gel sheets following surgical excision and laser treatment. These help keep the skin moist and make the keloid scars flatter and softer.

Pain and Discomfort During the Procedure

Surgery to remove keloids often involves pain. Patients usually feel discomfort during and post-procedure, which is controlled with medications. The area around a keloid is sensitive, and the pressure from cutting can cause quite a bit of pain. Since surgery includes injections to numb the area, those who don’t like needles may feel even more discomfort.

Laser treatment leads to less post-operative discomfort and minimizes tissue damage. The pain with laser removal feels like a mix of pressure and heat but is generally more bearable. The high number of injections required is typically lowered with lasers, as they can be done with just topical anesthesia. This can reduce discomfort, especially for those who dislike injections.

Laser treatment has fewer effects related to discomfort and pain. However, pain tolerance varies by individual. Both methods come with different levels of pressure and pain, and it’s important to talk with a healthcare provider about this before choosing a method.

Level of Invasiveness and Tissue Damage

Invasiveness of Surgical Procedures

Conventional surgery often requires cutting through different tissue layers. The nature of traditional surgery can harm surrounding tissue, which can lead to slow wound healing. Surgical excision might cause more keloids if not done carefully, creating a cycle of damage and healing.

When it is done correctly by experts such as Dr. Mendez and Dr. Salloum, this method of removal of keloid scars provides excellent outcomes for patients. For patients with gigantic keloids, surgical excision may be the preferred method of treatment as it allows for direct removal of the large scar tissue.

Tissue Preservation in Laser Techniques

Laser techniques, in most cases, save tissue. They use light to target cells accurately and reduce harm to other areas. This approach reduces the risk of keloid formation and helps wounds heal better. Lasers can break down the cell structure of keloids with minimal effect on nearby healthy tissue.

Long-Term Outcomes and Aesthetics

Precision surgery for keloid removal can give immediate results by taking away the keloid’s physical bulk. The surgeon’s skill is vital for good aesthetic outcomes. The right techniques can lower the chance of the keloid coming back and lead to smaller scars. After keloid surgery, a combination of therapies lessen scar building. 

Laser tools are precise and can target just the keloid, not touching the healthy skin, which helps the scar look better. 

The best long-term aesthetic results often come from mixing surgical and laser methods with other steps. The treatment plan should be based on individual scar traits and the likelihood of getting hypertrophic scars, to get the best outcomes.

Recovery Time and Post-procedure Care

After Surgery

The recovery time for patients who have had a keloid surgically excised varies. Typically, healing from surgical excision takes 1 to 2 weeks. During this period, patients are advised to limit activities that could exert pressure on the wound site. Following post-op instructions is critical for a good recovery and to help prevent the keloid from coming back. Routine check-ups with healthcare providers are crucial to monitor the healing of the wound and deal with any issues quickly.

Laser Treatment Healing

Laser treatment for keloids allows for a quicker return to daily activities, usually within a couple of days. Despite the reduced damage to the surrounding skin, several sessions may be necessary with breaks in between for the skin to heal properly. The care steps involve:

  • Using Silicone-based products to aid in skin healing.
  • Wearing pressure garments if advised, to apply pressure on the treated area.
  • Watching the skin for any negative responses or signs of infection.

Post-surgical excision or lasers for keloid scar may include a dose of post-procedure radiation to cut down the chances of the keloid returning. When needed, radiation doses are precisely determined and given in multiple sessions for safety and effectiveness. Patients undergoing radiation must shield their skin from the sun and adhere to all the care instructions from their providers.

Suitability for Different Keloid Types and Locations

Surgical methods are flexible in treating keloids of all types and locations. Surgeons adapt their approaches for various keloids, tackling anything from large, raised keloids to widespread hypertrophic scars. Surgery removes the keloid tissue and is often used with other treatments to stop it from coming back. Each method is chosen to lessen trauma and the chance of new keloids forming.

Laser therapy is a popular treatment option for keloids and works by breaking down the tissue. Its effectiveness varies, but combined with drug treatments, it can heal better. However, studies show that tough, hypertrophic scars may not respond as well to laser alone. The right treatment option takes into account factors like the keloid’s place on the body, past treatment response, and what the patient prefers.

For the best results, healthcare providers look at each keloid case to figure out the right mix of surgery, laser, and other therapies.

Keloid Treatment Choices

Every individual reacts differently to keloid treatments, as studies have shown. Personalized approaches are essential and tailored to each person’s unique situation. Reviews sometimes highlight new methods that could work well, but only the consistent observation of effects will show if they can be trusted in the medical field.

Dealing with keloid scars can be a difficult process, but it is important to remember that there are resources available to help. It is crucial to make informed decisions about treatment options for the well-being of your skin and overall peace of mind. Seeking guidance from experienced professionals who can customize an approach specific to your condition is essential.

Don’t hesitate to take the next step towards healing. Schedule a consultation with keloid treatment experts, and gain access to the expertise you need for effective treatment. Your journey to clearer skin begins with expert care.