July 13, 2026 | Uncategorized
She had covered the same earring back with her hair for three years.
The keloid underneath it was the size of a pea, raised and firm, from a piercing that never settled. She was not in for anything else, just that one spot, and she half-apologized for taking up my time with something so small. I told her what I tell everyone in that chair: the spot is small, but the scar it leaves is permanent, so it deserves to be done right.
A lot of patients come in about one specific thing: a raised scar on the ear, a mole on the face, a lesion they want gone. The difference between a plastic surgeon doing it and someone just removing the spot is that I am thinking about the final scar the entire time. These answers are from real consultations, anonymized.
“I Have a Keloid on My Ear. Can You Remove It?”
Yes, and it is one of the more straightforward things I do. Ear keloids almost always come from a piercing. I numb the spot, cut the keloid out, and re-close it, then lay in a little Kenalog, a steroid, to discourage it from coming back. The whole thing runs about twenty minutes under local anesthesia, and the only real ask afterward is that you skip the gym for roughly ten days.
“Will the Keloid Come Back?”
There is always some risk, and I will hand you the actual numbers instead of a vague reassurance. Across the board, recurrence sits around ten to twenty percent. But once we clean it up and close it well, most people are simply done with it, so the odds of it returning the way it was probably drop under five percent. The moment it starts to feel hard or look like it is trying to come back, you come straight in and we put in a touch more steroid to shut it down early.
“Where Do Keloids Actually Happen?”
This matters, because people worry about keloids in places they almost never occur.
| Common Keloid Sites | Rare or Essentially Never |
|---|---|
| Ears | Face (rare) |
| Shoulders | Eyelids (I have never seen one) |
| Sternum and chest | Genital area (different tissue, never seen one) |
| Joints, like knees and ankles |
Keloids are common anywhere there is tension or movement. They are very rare on the face, and on the eyelids I have honestly never seen one. The genital area is different tissue, more mucosa than skin and not under tension, so I have never seen a keloid there either. So if you are having eyelid or labiaplasty surgery and worried about keloids, that is not where they form.
“What About a Mole or Other Spot on My Face?”
This is where seeing a plastic surgeon pays off. Anyone can remove a lesion. The point of having me do it is that I prioritize the final scar, placing and closing the incision so that what is left behind is as invisible as possible, rather than just getting the spot off. On the face especially, that choice is something you live with for good.
“How Do You Keep Scars Looking Good Afterward?”
Beyond careful closure, old or healing scars can be softened with microneedling using PDGF, a platelet derived growth factor that is like PRP but more powerful and helps renew collagen. It takes a few sessions, and you can have that done at the Med Spa. For certain marks and discoloration, laser treatments can help as well, and we tailor the plan to the scar.
Why Small Procedures Still Deserve a Plastic Surgeon
I am a double board-certified plastic surgeon, certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, with a plastic surgery fellowship from the Mayo Clinic. A keloid or a mole is a small thing, but the scar it leaves is permanent, so it is worth doing right the first time, with a plan to prevent recurrence and protect the final result.
For the surgeon’s candid editorial take on why the scar is the whole point, see the companion essay on drworldwide.com, and for the full scar-refinement menu, see the version on swplasticsurgery.com.
Ready to Talk?
If there is a spot, a bump, or a keloid you want handled with the scar in mind, come see me. Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful.
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