Plenty of appointments at Southwest Plastic Surgery are not about a whole region of the body. They are about one spot: a raised scar on the ear after a piercing, a mole on the cheek, a lesion a patient just wants gone.
Dr. Frank Agullo tells patients that the difference between a plastic surgeon doing these and someone simply removing the spot is that he is thinking about the final scar the entire time. The spot is temporary. The scar is permanent. The questions below are from real consultations, anonymized.
Can a Keloid on the Ear Be Removed?
Yes, and Dr. Agullo says it is one of the more straightforward things he does. Ear keloids almost always trace back to a piercing. He numbs the spot, cuts the keloid out, and re-closes it, then lays in a little Kenalog, a steroid, to discourage it from returning. The procedure runs about twenty minutes under local anesthesia, and the only real ask afterward is that the patient skip the gym for roughly ten days.
Will the Keloid Come Back?
There is always some risk, and Dr. Agullo gives patients the actual numbers rather than a vague reassurance. Across the board, recurrence sits around ten to twenty percent. But once the keloid is cleaned up and closed well, most people are simply done with it, so the odds of it coming back the way it was probably drop under five percent. The moment it starts to feel hard or look like it is trying to return, the patient comes straight in and a touch more steroid is placed to shut it down early.
Where Do Keloids Actually Form?
This matters, Dr. Agullo notes, because patients worry about keloids in places they almost never occur.
| Common Keloid Sites | Rare or Essentially Never |
|---|---|
| Ears | Face (rare) |
| Shoulders | Eyelids (he has never seen one) |
| Sternum and chest | Genital area (different tissue, never seen one) |
| Joints, like knees and ankles |
Keloids set up shop wherever there is tension and movement. They are genuinely rare on the face, and on the eyelids Dr. Agullo has never seen one. The genital area is a different material entirely, more mucosa than skin and not under tension, so he has never seen one there either. So a patient bracing for a keloid before eyelid surgery or a labiaplasty can set that worry down.
What About a Mole or Spot on the Face?
Here is where having a plastic surgeon do it earns its keep. Anyone can take a lesion off, Dr. Agullo says. The reason to have him do it is that he is 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 possible, instead of just lifting the spot and moving on.
Med Spa Scar Care After the Procedure
Careful closure is only the first half. At Southwest Plastic Surgery, 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 is done at the Med Spa. For certain marks and discoloration, laser treatments can refine the result further. The surgery sets up the scar, and the Med Spa work polishes it over time.
About Dr. Frank Agullo
Dr. Frank Agullo is the founder of Southwest Plastic Surgery in El Paso, Texas. He is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, completed a plastic surgery fellowship at the Mayo Clinic, and has been named a Castle Connolly Top Doctor for thirteen consecutive years. A keloid or a mole is a small thing, he tells patients, but the scar it leaves is permanent, so it is worth doing right the first time.
For the surgeon’s candid editorial take, see Dr. Agullo’s essay on drworldwide.com, and for the full patient walkthrough, see the companion post on agulloplasticsurgery.com.
Ready to Talk?
If there is a spot, a bump, or a keloid you want handled with the scar in mind, the team is ready. Call (915) 590-7900, text 1-866-814-0038, or book online at swplasticsurgery.com. #StayBeautiful.
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