LAM FACIAL PLASTICS

I have two large keloids on each side of my jaw and a few small ones on chest and shoulders and back. I had it surgically removed 3 years ago on my face without radiation and it came back harder. I did some research on your site and found out radiation therapy within 24 hours of surgery has a 90% chance of it not coming back.

I don’t live in Dallas area. I am going to have surgery again with the same surgeon this time with radiation done the next morning. According to your videos and forums you seem to be an expert on this matter. My case is very similar to this one you’ve done. http://www.lamfacialplastics.com/procedures/reconstructive-plastic-surgery/scar-revision/

I know it’s still going to leave a smaller scar after surgery. My first surgery we did a dermabrasion 2 weeks after surgery to minimize the revised scar.

Do you recommed dermabrasion done after radiation?

Do you have any recommendations and tips for me and my surgeon based on your experience with keloids removal? I know the results are based on the work of surgeon and my ability to heal. I am hoping you can provide some insider information to help me and my doctor.

Can you provide contact info your oconlogist? I like to ask her for specifcs of type of radiation, dosage, and sessions based on her experisnce?

Thank you very much for your help in advance. I hope yon provide as much info as possible. I can see your work have helped many people around the world. Keep up the good work!

here is a simple answer to your question regarding dermabrasion: NOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO!

you do not want to bother a keloid. do not dermabrade a keloid. it can explode on you. almost any qualified radiation oncologist will know the settings for keloid. you must plan well in advance to have the radiation done. don't just walk in and have surgery and hope to get into the radiation doc's office. preplanning and coordinating the two services are critical. tension free keloid removal, multi-layered closure, non-dissolvable skin sutures, following relaxed skin tension lines are the key. then postoperative silicone sheeting to help things out after radiation i would also recommend. i don't have a brand that i am loyal to. there is scar guard, kelocote, etc.

Thank you Dr. Lam for your response. So I guess I will have to live with the new scar that is created when the keloids are removed. I am a little bit nervous because this will likely be my last final operation on it. But a normal scar will be better than a keloid scar. Should I expect the new scar to be longer or about the same length?

I am going to see my oncologist today to get everything scheduled and synchronized.

typically it should be about the same length if not slightly longer. you should ask your surgeon that question.
best,
sml

Is there any difference in the Oncologist? I went to MD Anderson in Houston and another one called SightLine Health in Houston. MD Anderson charges $600 and Sightline Charges $40 per session. Are the radiation going to be the same? Sightline said it’s the same, I haven’t talked to the MD Anderson DR yet. I am about to do that today.

Sorry I realize these are questions I need to ask my local doctors but I just really appreciate a second opinion by you because of your expertise.

honestly if you go to a qualified doctor, most likely it is the same. but i do not like to speak from ignorance. please perform your own research but i think you should be fine. the surgical technique is where it counts the most.
best,
sml

I just got back from MD Anderson Oncologist and confirmed that it's the same type of radiation and they both will work exactly the same. I will give my surgeon your recommendations of "tension free keloid removal, multi-layered closure, non-dissolvable skin sutures, following relaxed skin tension lines are the key"

But I believe he already knows what to do b/c of my previous keloid removal. I trust he will do a great job. I just hope I will heal well.

Thank you again for your time and response. I enjoyed reading your blog and videos. I will likely be reading your book recommendations while i am recovering after my surgery next month.

best of luck. i am sure you will be fine!