LAM FACIAL PLASTICS

Dear Dr. Lam:

I have a several keloids around my neck area - they are minor and aren't very noticeable. I have seen your video on keloid scarring treatments and I am very interested in scheduling an appointment with you - however, I am actually residing in Canada so i would really love to know a few questions before i pay the visit.

With regards to treatment, you claimed that the most effective method of treating keloids is through "surgical excision" alongside with radiation therapy (within 24 hours of the surgery). My question is..
1. Would the keloid completely heal (as in absolutely NO scar remaining/very light blemish) and become flat (given that the treatment was successful). I am still a bit fuzzy about what the word "successful" means since I've read in many articles stating that there is "no effective way to treat keloids up till this day". I would really hope that "successful treatment" of keloid means that it could restore the area back to my original skin color.
2. Under what restrictions would i be prohibited from undergoing radiation therapy? Does the size of the keloid (or age, sex, ethnicity, etc) prohibit me from undergoing radiation therapy?

Thank you soo soo much for your attention..
I am really in desperate need of help..
Thank you.

With regards to treatment, you claimed that the most effective method of treating keloids is through "surgical excision" alongside with radiation therapy (within 24 hours of the surgery). My question is..
1. Would the keloid completely heal (as in absolutely NO scar remaining/very light blemish) and become flat (given that the treatment was successful). I am still a bit fuzzy about what the word "successful" means since I've read in many articles stating that there is "no effective way to treat keloids up till this day". I would really hope that "successful treatment" of keloid means that it could restore the area back to my original skin color.
OBVIOUSLY, THERE ARE NO GUARANTEES OR 100% ASSURANCES BUT REMOVAL OF A KELOID WITH RADIATION SHOULD MOVE A SUCCESS RATE UP TO 95% IN MOST CASES. THIS MEANS THAT THE FULL BIG KELOID SHOULD NOT COME BACK BUT YOU WILL ALWAYS HAVE A SCAR OR LINE THERE. HOW VISIBLE THE LINE LOOKS IS UP TO A GOOD PLASTIC SURGEON AND HOW YOUR SKIN HEALS. IF THERE IS SKIN COLOR CHANGES AROUND IT THEN I DON'T THINK YOU SHOULD TRY TO EXCISE ALL THE NORMAL SKIN OUTSIDE OF THE KELOID BECAUSE THAT COULD PROMOTE MORE KELOID FORMATION. IF THE SKIN COLOR CHANGE IS WITHIN THE KELOID, THEN YES, IT SHOULD NOT BE THERE AFTER REMOVAL IF IT IS PART OF THE KELOID BEING EXCISED.
2. Under what restrictions would i be prohibited from undergoing radiation therapy? Does the size of the keloid (or age, sex, ethnicity, etc) prohibit me from undergoing radiation therapy?
THAT IS SOMETHING YOU NEED TO ASK A RADIATION ONCOLOGIST NOT ME. TYPICALLY, PREGNANCY OR POSSIBLY OTHER HISTORY OF HEAD AND NECK MALIGNANCY BUT I CERTAINLY DON'T KNOW. THAT IS WHY I PARTNER WITH A RADIATION ONCOLOGIST TO WORK WITH ME.
best,
sml

Dear Dr. Lam

Thank you so much for the prompt response!
Having said that removal of a keloid with radiation should move a success rate up to 95% and that how visible the scar looks is up to a good plastic surgeon, I was just wondering if you (or your team) is able to perfrom the surgical excision?
Also, would the "itchiness" feeling stop after the treatment?
I am just crossing my fingers that the keloid will not come back or become "bigger" after the treatment - having a scar or 2 is okay with me.

Please get back to me.
Thank you so much Dr. Lam!

yes, i do good keloid removals but to get the best results you must preschedule the time with the radiation oncologist. as mentioned, you must have your radiation first treatment within 24 hours of excision. the only way to do that is to have the radiation pre-planned.
best,
sml

Dear Dr. Lam

Sorry that i keep asking questions!! But just want to verify that if i do undergo surgical excision AND undergo radiation therapy, is there a likelihood that the keloid (may or may not) become even BIGGER than the original keloid? Because my keloid is small, i am just afraid that after the surgery and the radiation therapy that it would become "larger" than before. Has this ever happened in the past (given that radiation therapy has been carried out within 24 hours of the excision)?
Thank you soo soo much.
Best.

i have not seen it. all things are possible. however, the reason for the radiation is to make this likelihood extremely unlikely.

In other words, would you reccomend a surgical excision and radiation therapy treatment if the keloid is small and has not "expanded" for the past year? Is there risk that undergoing this treatment would result in a keloid even bigger than the original one? Sorry, i didn't think i made myself clear on the previous post.
Thank you very much Dr. Lam

i can't recommend per se a treatment regimen by just responding in general in these posts. however, suffice it to say that one of the most assured methods to minimize a keloid recurrence let alone worsening of it is to pre-plan radiation therapy and to receive professional advice from a radiation oncologist.

Thank you for all your generous responses Dr. Lam!

my pleasure!