Not every patient who sees me wants a whole region of the body changed. A lot of them walk in about one specific spot.
A raised scar on the ear after a piercing. A mole on the cheek that has been there for years and finally bothers them. A lesion they just want gone. These are small procedures, the kind a lot of doctors treat as a quick in-and-out. Here is my whole argument for why they are not.
When I do one of these, I am thinking about the final scar the entire time. That is the difference between a plastic surgeon doing it and someone simply removing the spot. The spot is temporary. The scar is permanent. So the scar is what I am actually operating on. These answers are from real consultations, anonymized.
“I Have a Keloid on My Ear. Can You Remove It?”
Yes, and honestly it is one of the more straightforward things I do.
Ear keloids almost always trace back to a piercing. I numb the spot, cut the keloid out, and re-close it cleanly. Then I lay in a little Kenalog, a steroid, to discourage it from coming back. Start to finish it runs about twenty minutes under local anesthesia, and the only real ask afterward is that you skip the gym for roughly ten days. That is the whole commitment.
“Will the Keloid Come Back?”
There is always some risk, and rather than hand you a vague reassurance, I will give you the actual numbers.
Across the board, recurrence sits somewhere 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 real protection is what happens next. 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 before it builds. Caught early, it almost always backs off.
“Where Do Keloids Actually Happen?”
This matters, because people worry about keloids in places they almost never occur. Here is the honest map.
| 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 set up shop where there is tension and movement. The face is genuinely rare. On the eyelids I have never seen a single one, and the genital area is a different material entirely, more mucosa than skin and not under tension, so I have never seen one there either. So if you are heading into eyelid surgery or a labiaplasty and you are bracing for a keloid, you can let that worry go. That is not where they grow.
“What About a Mole or Other Spot on My Face?”
Here is where having a plastic surgeon do it actually earns its keep.
Anyone can take a lesion off. The reason to have me do it is that I am building toward the final scar the whole time, choosing where the incision sits and how it closes so that what remains is as close to invisible as I can make it, instead of just lifting the spot and moving on. On a face, the gap between those two approaches is something you look at in the mirror for the rest of your life.
“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 it done at the Med Spa. The surgery sets up the scar, and the skin work refines it over time.
The Credential Behind the Small Stuff
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 patient-facing walkthrough, see the companion post on agulloplasticsurgery.com, and for the scar-refinement menu, including microneedling and laser options, 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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