Can You Have Plastic Surgery If You Form Keloids or Raised Scars?

Having a history of keloids or raised scars does not automatically mean that you cannot have plastic surgery. However, it does mean that your risk of developing an abnormal scar after a new operation may be higher than average. The decision should be made carefully with a qualified plastic surgeon, taking into account the procedure, the planned incision site, your previous scar behaviour and the expected benefits of treatment.

In Short

Plastic surgery may still be possible for people with a history of keloids or hypertrophic scars, but suitability must be assessed individually by a qualified surgeon. Your scar history, the planned incision site, wound tension and the expected benefit of surgery all matter. Scar-management measures may reduce risk, but they cannot guarantee that a keloid or raised scar will not develop.

At Estexper Clinic, patients considering treatment in Turkey should discuss any previous keloids, hypertrophic scars or unusually prominent surgical scars during their consultation. A thorough assessment before travelling can help clarify whether surgery is appropriate and whether additional scar-prevention measures may be needed.

It is important to understand that no treatment plan can guarantee that a keloid or hypertrophic scar will not develop. Nevertheless, careful surgical technique, reduced wound tension and planned postoperative care may help manage the risk.

What is the difference between a keloid and a raised scar?

The terms “keloid” and “raised scar” are sometimes used interchangeably, but they do not describe exactly the same thing.

Keloid scars

A keloid is an overgrown scar that extends beyond the original boundaries of the wound or injury. It may continue to enlarge over time and can be raised, firm, itchy, tender or uncomfortable. Keloids can develop after surgery, trauma, burns, piercings or relatively minor skin injuries.

Hypertrophic scars

A hypertrophic scar is also raised and may appear thick or firm, but it generally remains within the margins of the original wound. Some hypertrophic scars may gradually become flatter or less noticeable over time, although the course varies between individuals.

Correctly identifying the type of scar is important because it helps your doctor assess your likely response to a future operation. A dermatologist or plastic surgeon may examine previous scars and ask how they changed after the original injury.

Does a history of keloids rule out plastic surgery?

Not necessarily. Selected patients with a history of keloids or hypertrophic scars may still be considered for plastic surgery, but the decision is individual rather than automatic. Your surgeon may consider:

• Whether your previous scar was a true keloid or a hypertrophic scar
• How large, active or symptomatic the previous scar is
• Whether you have developed abnormal scars after several different injuries or operations
• The location and length of the proposed incision
• The amount of tension likely to be placed on the wound
• Whether the expected benefit of surgery justifies the possibility of a prominent scar
• Your ability to follow a long-term postoperative scar-care programme

Patients with a strong tendency to form keloids may be advised to proceed more cautiously, postpone elective surgery or consider whether the expected improvement is sufficient to justify the risk. This is especially relevant when the procedure would create a scar in an area where you have previously formed an abnormal scar.

A consultation cannot remove the risk, but it can help you make an informed decision. You should be given realistic information about possible wound-healing problems, recurrence and the limitations of preventive treatment.

Why can plastic surgery cause abnormal scarring?

Scar formation is a normal part of wound healing. In people who are prone to keloids or hypertrophic scars, the healing response may produce excessive scar tissue. Several factors can influence the final result.

Mechanical tension across a healing wound is one important consideration. Prolonged inflammation, infection or delayed healing may also increase concern about abnormal scar formation. The body site and the individual’s personal history are relevant as well.

For this reason, prevention begins with reducing avoidable stress on the incision and supporting uncomplicated healing. However, even excellent surgical care cannot guarantee a flat or barely visible scar in someone who is genetically or biologically predisposed to keloids.

How is suitability assessed before surgery?

Before recommending surgery, a qualified physician should review your medical and scar history in detail. If you are an international patient travelling to Turkey, it is helpful to provide clear photographs of previous scars and any relevant medical records before an in-person appointment.

Your consultation may cover:

• When each previous scar developed and whether it grew beyond the wound
• Symptoms such as itching, pain, sensitivity or continued enlargement
• Previous treatments, including injections, silicone products, pressure therapy or scar surgery
• How your scars responded to earlier treatment
• Any history of infection, delayed wound healing or wound separation
• Medical conditions or medicines that may affect healing
• Your expectations regarding the appearance of the new scar

Your surgeon may also examine the proposed treatment area and discuss whether the planned incision can be placed or closed in a way that limits tension. In some cases, referral to a dermatologist or another specialist may be appropriate.

How can the surgical plan reduce scar risk?

When surgery is considered appropriate, the plan may include several measures intended to support uncomplicated healing. Guideline-based approaches commonly emphasise minimizing mechanical tension, using atraumatic handling of the tissues and closing the wound in layers where suitable.

A multilayer closure can help distribute tension rather than concentrating it at the surface of the skin. The exact technique depends on the procedure and the anatomy involved. Your surgeon may also consider incision placement, wound support and methods of reducing movement during the early healing period.

It is important to understand that these measures are risk-reduction strategies, not guarantees. The most suitable approach may differ between patients and between surgical sites.

What scar treatments may be used after surgery?

For patients who are predisposed to keloids or hypertrophic scars, postoperative scar management should ideally be planned before the operation. Possible measures may include:

Silicone gel or silicone sheets

Silicone preparations are commonly recommended after the wound has healed sufficiently for them to be used safely. They may help improve the appearance or symptoms of some raised scars. Your surgeon should explain when to begin, how long to use the product and how to monitor the skin.

Pressure therapy

Pressure therapy may be considered where it is practical and anatomically suitable. Its usefulness depends on the treatment area, the design of the pressure device and whether the patient can use it consistently.

Corticosteroid injections

Corticosteroid injections may be used if a scar becomes raised, active or symptomatic, or as part of a preventive plan in selected circumstances. They are not appropriate for every patient and should be administered only when recommended by a qualified clinician.

Other specialist treatments

Additional treatments may be considered according to the individual scar and the doctor’s assessment. Evidence does not establish one universally effective protocol, so care is often individualized and may combine more than one method. Specialist treatments such as radiotherapy require particularly careful risk-benefit assessment and are not routine for every patient.

What is recovery like when you are prone to keloids?

Recovery may be similar to that of other patients in some respects, but scar monitoring is especially important. You should follow the clinic’s wound-care instructions closely and attend recommended follow-up appointments, whether you remain in Turkey or return home after treatment.

Contact your surgical team promptly if you notice increasing redness, discharge, wound separation, worsening pain, significant swelling or other signs that healing is not progressing normally. Infection and prolonged inflammation may complicate healing and should not be ignored.

Once the incision has healed enough for scar treatment, your clinician may recommend silicone, pressure therapy or another measure. Do not apply products to an open or infected wound unless specifically instructed. Protecting the healing area and avoiding unnecessary tension are also important parts of aftercare.

Scar maturation can take time, and a scar may change in colour, thickness and texture during recovery. Long-term follow-up may be recommended because keloids can develop or recur after an interval of healing.

What are the risks and limitations?

The main concern is that a new incision could produce a hypertrophic scar or keloid. A prominent scar may be uncomfortable, itchy or cosmetically distressing. It may also require additional treatment.

If an existing keloid is surgically removed, surgery alone carries a particularly high risk of recurrence. The 2020 S2k guideline reports recurrence rates of 45%–100% when keloids are treated with surgery alone. The American Academy of Dermatology also warns that nearly all keloids may return after surgical removal without effective adjunctive management.

These figures relate to treatment of keloids themselves and should not be interpreted as a guaranteed outcome for every elective plastic surgery procedure. Nevertheless, they illustrate why surgery alone is generally discouraged as a treatment for an existing keloid. When removal is necessary, multimodal treatment and long-term follow-up are commonly considered.

Even when preventive measures are used, abnormal scarring may still occur. The available evidence does not identify a single method that reliably prevents keloids in every patient.

Can an existing keloid be removed before plastic surgery?

Removing an existing keloid is not usually a simple solution. Excision creates another wound, and the new scar may become larger or recur. The NHS cautions that removing a keloid can result in a larger recurrent scar.

If treatment of an existing keloid is medically or functionally necessary, a specialist may recommend a combination of approaches rather than excision alone. The specific plan depends on the scar’s size, location, symptoms, previous treatments and the patient’s risk profile.

If you are considering cosmetic surgery and also have an existing keloid, ask whether it is safer to address the scar first, combine treatments or avoid an additional operation. This decision requires an individual clinical assessment.

Questions to ask your surgeon

Before choosing surgery, consider asking:

• Do my previous scars look more consistent with keloids or hypertrophic scars?
• How does my scar history affect the proposed procedure?
• Where will the incision be placed, and how will wound tension be reduced?
• What scar-management plan will begin after surgery?
• Could I need silicone, pressure therapy or corticosteroid injections?
• How long will follow-up be needed?
• What arrangements are available if I return home after treatment in Turkey?
• What symptoms should prompt urgent medical advice?

International patients should also clarify how postoperative reviews will be arranged, who to contact outside clinic hours and whether a local doctor in their home country may need to participate in follow-up care.

Frequently asked questions

Can I have plastic surgery if I have had one keloid?

Possibly, but a previous keloid places you in a higher-risk group. Your suitability depends on the procedure, scar location, previous behaviour and the expected benefits. A qualified surgeon must make the final assessment.

Are hypertrophic scars less concerning than keloids?

Hypertrophic scars generally remain within the original wound and may flatten over time, while keloids extend beyond the wound margins. Both can indicate a tendency toward abnormal scarring and should be discussed before surgery.

Can silicone products guarantee that I will not develop a keloid?

No. Silicone products may be recommended as part of postoperative scar care, but they do not guarantee prevention. The overall plan should be tailored to your history and the operation.

Is surgery alone suitable for treating a keloid?

Usually, surgery alone is discouraged because recurrence is common. If surgery is necessary, a specialist may recommend additional treatments and long-term monitoring.

Making an informed decision

A history of keloids or raised scars does not automatically rule out plastic surgery, but it changes the conversation. The decision should balance the expected improvement against the possibility of a prominent or symptomatic scar and the need for prolonged aftercare.

Choose a qualified plastic surgeon who will examine your previous scars, explain uncertainty honestly and prepare a postoperative management plan before treatment. At Estexper Clinic in Turkey, international patients should share their full scar history during the consultation and ensure they understand the follow-up arrangements before booking surgery.

If you are considering treatment, seek an individualized medical assessment rather than relying on general information online. Your physician can determine whether surgery is appropriate and which risk-reduction measures may be suitable for you.

Explore our Plastic Surgery services in Turkey for an overview of treatment options and individual assessment.

Medical References

1. S2k guidelines for the therapy of pathological scars (hypertrophic scars and keloids) – Update 2020 — German Dermatological Society / Journal der Deutschen Dermatologischen Gesellschaft.
2. The Most Current Algorithms for the Treatment and Prevention of Hypertrophic Scars and Keloids: A 2020 Update of the Algorithms Published 10 Years Ago — Plastic and Reconstructive Surgery Global Open / PubMed Central.
3. Keloids and Hypertrophic Scars — Dermatologic Clinics / PubMed.
4. Keloid scars: Diagnosis and treatment — American Academy of Dermatology.
5. Keloid scars — NHS.