LAM FACIAL PLASTICS

Hi Dr Lam.

My name is Jake, I am 23 years old, and have suffered with keloid scars for the past 5 years. I have a huge on one my chest, and 3 on my shoulder, all of these began as a result of acne/pimples. They have been growing incredibly slowly for the last 5 years. The ones on my shoulder stayed as tiny raised bumps for the first 3 years or so, then suddenly over the past year and a half have grown significantly. The one on my chest is Just huge.. i have never shown it to a single human being.. it is too ugly i just cant bring my self to do it.

I have learned to deal with these, they affect my life pretty heavily, i've become somewhat of an introvert because of them, but i try real hard not to think about it, or show them to anyone, and just get on with life.

My main concern however, is i have a scar on my lip, which i recieved in about july 2009 after being punched, i recieved 3 stitches, and it seemed to heal ok, and i have not payed any attention to it over the last year and a half. Now, i dont know whether it is me suddenly starting to stress over it, or pay close attention to it, but i swear it is starting to seem more noticable. In certain light it looks like it produces a shadow that i never noticed before. I am starting to stress out, due to my past experience with keloids, will this one start to grow now?

Is it possible for a keloid to begin to grow, a year and a half after the initial surgery?.

I have attached photos of both my chest keloid and lip scar.

What would my best option be for stopping a keloid from developing in the very early stages?
I have never had any injections or used any kind of treatment really.
I live in Australia, would you recommend i get steroid injections?
Any help would be appreciated, i really dont want to be a year from now saying... "i really wish i did something earlier"

thanks
-Jake

so sorry this has affected you so much. let's address each separately:

1. as far as the lip is concerned, it is truly impossible to get a keloid on the face and much less so on the lip. the face is defined as anything above the chin below the hairline and in front of the ears. you can get a hypertrophic scar (which is what you have) that does not tend to grow like a keloid so your lip should never look like your chest. however, there are ways to get it under control. i do not prefer steroids as they risk atrophy and skin changes that are unfavorable. i prefer 5-fluoruracil injections (5FU for short). that is a safer way to go.
2. as far as the chest, first a disclaimer, i am a facial plastic surgeon and this site is dedicated only to facial cosmetic and reconstructive surgery so i do not operate on things below the neck. however, in general keloids respond similarly throughout the body. i would consider in your case excision by a good plastic surgeon followed by TIMED radiation to be done within 24 hours after quality excision. it is so important that the radiation be timed or the result will fail. you will trade off a keloid for a scar. i personally would not excise it without radiation as the risk of return and growing even bigger is far greater. finally, in answer to your question, keloids can grow almost any point in your life unfortunately typically due to infection, trauma, or manipulation so whatever you do try not to bump it hard or squeeze on it or play with it or it will grow. hope that helps as a start.
best,
sml

Thank you for your reply. It is good to know that my lip will never become as big as my other keloids. When you mentioned that bumping and touching/irritating the scars can aggravate them, i think this could be where i have gone wrong in the past.
I've read on certain websites and forums that sometimes massaging the scar can help, So at times i have, purely for peace of mind, rubbed vitamin e, bio oil etc, into the scars... it seemed like a better idea than doing nothing and just watching them not improve. I am beginning to think this probably caused them to grow, especially if i was massaging them to hard.
A few nights ago i popped a vitamin e capsule and massaged some into my lip, around the same time i begain to realise i could notice it more than ever before. I dont think i will do that ever again.

Today i booked in to see a plastic surgeon in june. I'm going to ask him about the 5-FU injections, ask him if he has experience with them.
Today i also bought some silicone gel from a pharmacy, i figure it certainly cant hurt right?
Do you think it will help to slow any potential growth of my lip scar between now and my consultation in june? Or am i too late for silicone to have any effect. The instructions say works on old and new scars, so i guess it may have some effect if i apply it religiously.

Once again thank you very much for your information! You're a huge help!

silicone can help but very minimally. good luck with everything!