Hello Dr. Lam. Thank you for helping so many people with your online advice (as well as in-clinic services of course!).
I had a pre-melanocystic mole removed last fall. It was just to the right of my sternum, just above the line of my breast tissue. So an area that would get a lot of pulling as it healed (I am a 36 DD). My GP performed the excision, and he simply carved a hole around the mole edges, going deep enough to remove it all. Total incision was just under a half inch in diameter. Then he sewed the hole up in a straight line. As it healed, though I wore a bra 24/7 and support bandaging, the stitches were pulled on and when they were removed a week later the incision just sprang open. It did not bleed though, as it was a seasoned circle of tissue already, meaning it had begun to heal over the original circular excision, as opposed to the two edges knitting together and healing in a straight line. I now have a very raised, round red keloid scar, which itches constantly and is painful. My GP recommends excising the scarred tissue and trying again, but I am concerned that this is the wrong approach and will have the same results.
What is the correct way to excise a circular-shaped area of tissue? I do not care at all if I have a flat scar, be it a longer line or zig zag or what have you. I just do not want the pain of another keloid. It is right on the line where my seat belt sits in the car, where my v-neck shirts lie, my shoulder bag, etc so it is constantly painful or irritated by daily life.
I would like to approach my GP with any information that could yield a better result, and because of the way it looked after we removed the stitches, I'm concerned that essentially digging a hole in my chest is not the best way to go about removing this tissue. It is a scar the size of a dime at this point. I recognise that there are post-operative therapies such as steroid injections and gels that will help as well, but I'd like to hear from you if the type of incision does matter, and if so, on a scar of this size and shape, what type of incision you would recommend.
Thank you very much for your time.