Keloid surgery is a procedure to remove or reduce the size of keloid scars. Keloids are overgrown scar tissue that goes beyond the original injury site. They can range in size from very small to quite large. Keloid surgery aims to improve the appearance and symptoms of problematic keloids.
The length of keloid surgery can vary based on several factors:
Size and Location of the Keloid
Larger keloids generally take longer to remove than smaller ones. The location on the body also impacts surgery time. Areas with more delicate skin and intricate anatomy, like the face, ears and neck, require more precision and care which extends the length of the procedure.
Keloid on the Chest
For a small keloid on the chest, removal may take around 1 hour. A larger or multiple chest keloids could take 2-3 hours.
Keloid on the Arm
Removing a small singular keloid on the upper arm often takes about 1 hour. Larger or multiple arm keloids can take 2-3 hours.
Keloid on the Ear
Ear keloids are very common. Small ear keloid removal takes at least 1 hour due to the intricate nature of the ear anatomy. Larger or multiple ear keloids require 2-4 hours typically.
Keloid on the Face
Facial keloids, such as on the cheeks, chin, lips or nose, often take 2-3 hours even if relatively small. The sensitive facial skin and complex nerves and muscles require extra care and precision.
Surgical Technique
The technique the surgeon uses impacts length of surgery as well. The options include:
Excision
Excision involves cutting out and removing the entire keloid scar. This is the quickest technique, often taking 1 hour or less for a small singular keloid. Excision alone has a high recurrence rate so other techniques are often incorporated.
Excision + Adjuvant Therapy
Excision combined with another technique like radiation or steroid injections extends the surgery time. The adjuvant therapy is performed right after excision. This combined approach takes about 2-3 hours typically.
Incisional Techniques
Incisional techniques like shaving or cryosurgery aim to reduce the keloid’s size rather than remove it completely. Thislayered approach takes longer, around 2-3 hours even for smaller keloids.
Laser Therapy
Laser resurfacing or ablation techniques vaporize surface layers of the keloid while leaving deeper tissue intact. This meticulous approach can add 1-2 hours beyond excision alone.
Use of Anesthesia
The anesthesia used during keloid removal impacts length as well. Options include:
Local Anesthesia
Injections of lidocaine or other numbing agents around the keloid take effect quickly, allowing faster surgery start times. But intermittent injections are needed to maintain numbness during longer procedures. This can add about 30 minutes or more beyond the keloid removal itself.
Regional Anesthesia
Regional anesthesia blocks sensation to a larger portion of the body. Types like nerve blocks or epidurals take longer to administer and require monitoring, adding at least an hour of time before and after surgery.
General Anesthesia
General anesthesia puts a patient completely asleep and also requires more pre-op and post-op time. The anesthesia itself adds at least an extra hour in most cases.
Extent of Any Additional Procedures
Some keloid removals are performed as standalone procedures. But it’s common for other interventions to be done at the same time if needed. These additions can lengthen the total surgery duration. Examples include:
Scar Excision
Excising non-keloid scar tissue beyond the main keloid area takes additional time, especially if scars are widespread. This may add 30-60 minutes.
Tissue Expander Placement
Tissue expanders are often inserted during keloid removal on the earlobe. This device placement can require an extra 30 minutes per device.
Skin Grafting or Flap Closure
Larger wound areas may need skin grafting or local flaps to close the site, which can require 1-2 hours beyond the initial scar removal.
Surgeon’s Skill and Experience
A surgeon highly experienced in keloid surgery may work more quickly and efficiently than those with less specialized expertise. Board-certified, fellowship-trained specialists often operate faster due to their mastery of technique.
Use of Operative Microscopes
Some surgeons utilize specialized operative microscopes during keloid removal. This equipment provides enhanced visualization and precision but may involve added setup and adjustment time.
Conclusion
In general, keloid surgery takes 1-3 hours depending on the keloid size and location. Smaller (less than 2 cm), singular keloids take around 1 hour or less. Larger (over 5 cm), multiple, or highly complex keloids can take 3 hours or more. Use of adjuvant therapy, microsurgical techniques, and additional procedures extends the length as well. Skill of the surgeon is also a factor, with specialists able to operate efficiently. Discuss expected surgery time with your doctor during consultation.
Keloid Surgery Duration Table
| Keloid Location | Small Keloid | Large or Multiple Keloids |
|---|---|---|
| Chest | 1 hour | 2-3 hours |
| Arm | 1 hour | 2-3 hours |
| Ear | 1 hour | 2-4 hours |
| Face | 2-3 hours | 3+ hours |