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Neck Keloids

Treatment of keloids on the neck and chest

Neck keloids and scars are quite common in all age groups. 

Neck Keloids are especially disturbing for patients as it is often difficult to completely cover the scar with clothing.  Keloid scars can be longitudinally (vertically) oriented, or transverse (horizontal).  Most commonly, keloid scars on the neck occur as a result of thyroid surgery or carotid artery surgery.

 

 

Neck keloids can present with a number of problems, including cosmetic and functional. The neck is a dynamic part of the body and contains many important physiologic structures, including nerves, major blood vessels, lymphatics, muscles, esophagus, and trachea.  Intrusion of keloid scars beyond the normal limits of the dermis may impinge on the normal function of these structures, leading to secondary problems such as neck contracture, compression symptoms, and chronica inflammation.  If progressive, neck scars can cause severe limitation in activity and physiologic function.

Fortunately, most cases of neck keloids are diagnosed and treated early.  Keloids can present with a number of different symptoms, including the following listed below.  If you are experiencing symptoms associated with your keloid scars, it is important that you seek the expertise of Dr. Karamanoukian in the early phase of keloid growth. 

 

TREATMENT OF THYROIDECTOMY SCARS AND THYROIDECTOMY KELOID SCARS

 

A thyroidectomy procedure is designed to remove the thyroid in its entirety, or a partial lobe of the thyroid.  Thyroidectomy surgery is usually performed in the setting of malignancy, or as an exploratory procedure to diagnose a thyroid nodule.  Most, if not all thyroidectomy scars are horizontally oriented in the lower pole of the neck.  There are many dimensional variations in thyroidectomy scars, encompassing the entire anterior neckline or a partial variant thereof.

Keloid scars and hypertrophic scars of the lower neck can form as a result of a thyroidectomy procedure.  Scars can become widened, thick, depressed, and hyperpigmented.  Depending on the combination of problems, Dr. Karamanoukian can address these issues with a combination of surgery, TAC injection, subcision, scar revision, and laser.  In most cases, scars can be dramatically improved with non-invasive modalities. 

  1. Depressed Neck Scars: The platysma is a thin muscle that covers the anterior neck.  It provides dynamic function to the anterior neck and acts a a protective barrier for the deeper structures of the neck.  After surgery, the deep platysmal sutures may not provide enough tension relief and may dehisce before final wound healing. If this occurs, the neck scar may become depressed and widened. 
  2. Keloid Neck Scars:  A keloid scar is defined by a hyperproliferation of collagen growth within a wound with no clinical endpoint to maturity.  Keloid scars on the neck can be caused by excessive collagen deposition in the clinical setting of poor wound healing or excessive wound tension.  These factors may lead to a thickened scar that grows beyond the plane of the skin.  In severe cases, the neck keloids may become pigmented, painful, and may even cause neck contracture. 
  3. Hyperpigmented Neck Scars: All scars have a tendency to hyperpigment with time. Sometimes the hyperpigmentation or darkening of scars relates to sun exposure, the degree of inflammation, or the patient's skin complexion.  Whatever the cause, hyperpigmented scars can be improved with topical creams and chemical peels.  The process may take months to acheive final results.  Patients often request quick resolution of the pigmented scars, but a more regimented, long term management may produce more effective and permanent changes. 

Celebrities with Neck Scars: 

Elizabeth Taylor was rumored to have a neck scar that resulted from an emergency tracheotomy in the early sixties. The scar was vertical in direction and gradually improved as she got older. 

Sharon Stone appears to have a textural neck scar near the midline of her neck. Often, textural neck scars are hypopigmented and lack the appearance of normal skin. 

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