The World's Top Keloid Expert
Welcome to the office of Dr. Raffy Karamanoukian, a disciplined double board-certified plastic surgeon and leader in the management of keloid and surgical scars. In our center, we focus on relieving patients from the burden of cosmetic and functional scars. We see patients from all over the world, manage and consult on scars from other plastic surgeons through scheduled conference calls, and diagnose patients through interactive virtual platforms. It is our goal to optimize scar treatments and utilize the most technologically-advanced lasers and RF platforms for scar relief.
Dr. Karamanoukian is one of the most sought after surgeons in the field of scar management. As a plastic surgeon, he focuses on the functional benefits of scar removal and optimizes cosmetic results in order to restore anatomic form to a patient suffering from scars. Whether your scar is surgical, traumatic, or congenital, we have methods to minimize the cosmetic and functional burden of your scar.
Our treatments have been formulated as scar protocols by Dr. Karamanoukian. He has appeared on many media platforms, including The Doctors, Good Day LA, Al-Jazeera, and nationally-sydicated television shows highlighting his approach to scar therapy.
What are Keloids?
Keloid scars affect tens of millions of people and they are the result of hyperactive wound healing which leads to an overproduction of collagen, elastin, and inflammatory mediators. Unlike normal scars, keloids can grow beyond the original skin injury, often extending above the plane of the skin and beyond the original borders of the skin incision. Because keloids continue to grow, they require a more advanced treatment protocol than those offered for scar revision. Even after a keloid is removed, it can produce growth factors that cause regrowth. At Kare Plastic Surgery in Santa Monica, Dr. Karamanoukian utilizes cutting edge treatments to control keloid volume and reduce the risks of recurrence.
The first step in managing your scar is identifying whether the abnormal tissue is keloid growth or normal scarring. Sometimes, the diagnosis is not that easy and surgeons often treat keloid scars without identifying the source of inflammation. Keloids may often be accompanied by symptoms of itching, pain, skin tightness, burning, or limitations in range of motion.
Scar treatments have advanced the way we look at scars on the skin. Years ago, there were few effective treatment options for unwanted scars. With advancements in laser and topical therapy, we now have a greater ability to modify scars and make them look more like our normal skin. Unlike the majority of skin scars, keloids represent a unique problem as they are associated with chronic inflammation. Keloids tend to grow larger with time, recruiting adjacent skin and advancing horizontally and vertically within the matrix of the dermis and subcutaneous tissue. There are many reasons that men or women develop these abnormal scars, including:
- Plastic Surgery incision
- Skin Burns
- Skin Trauma
- Acne (Cystic acne on the shoulders or chest)
- Earlobe piercings
- Skin inflammation
In our Los Angeles plastic surgery center, we employ a HIDEF protocol that can reduce the inflammation associated with keloids, reduce the bulk of your keloid, resurface your skin, and help manage the scar so that keloids have less of a chance of recurring. Our treatment protocols may take months to complete, but can dramatically affect your scar keloid.
Do I have a keloid or a hypertrophic scar?
We are often asked by our patients whether a scar is a keloid or a hypertrophic scar and the distinction is not so black and white. Scars can have a tendency to keloid and hypertrophy based on their degree of inflammation and growth curves. A scar can have both components and be classified as both keloid and hypertrophic. We make distinctions when there are clear signs that a hypertrophic (or overgrown) scar begins to exhibit characteristics that make them grow beyond the original footprint of the skin injury. In other words, we look at the initial skin injury and if a scar begins to encroach on adjacent tissue, it is often labelled as a keloid. Some scars have characteristics that make them either hypertrophic or keloid and there is definitely overlap in the definition.
Acne and Keloids?
There is no doubt that keloids can be associated with acne and this is a common phenomenon on the jawline, chest, and shoulders. Sebaceous oil glands can produce sebum that can may be colonized with bacteria and other pro-inflammatory agents that can incite the body's wound healing process, ultimately leading to keloid growth on the skin. These keloids can be multiple and can cause pain and itching locally at the areas of growth. Acne keloids are commonly treated at our office by first managing the acute keloid growth and then addressing the inflammatory cystic acne that is causing new keloids to grow. Some patients may benefit from Accutane to address the cystic acne. Surgery is less commonly used in these acne keloids because recurrence after surgery is very high unless the lesion excision is coupled with radiation SRT. Our office collaborates with experts in the field of Radiation Therapy in order to facilitate the process if that is required. In most cases, acne keloids can be managed by lasers and injections.
What are my first steps towards treating my keloid?
If you are suffering from keloids, join the countless thousands of patients who have benefitted from the keloid protocols developed by world-renowned surgeon Dr. Raffy Karamanoukian. In our practice, we understand keloids from a clinical, molecular, and biologic level; which allows us many advantages in treating this unique and progressive problem. Kare Plastic Surgery offers in-office treatments in Santa Monica and Beverly Hills, and virtual examination and consultations for patients who are travelling from other parts of the United States and abroad. Consultations can be scheduled by calling our patient care coordinators who can assist you in the basics of keloid therapy. Specific recommendations for keloid management are based on a visualization of your keloids and an assessment of your medical history.
Why Dr. Karamanoukian for keloid scars?
There are so many reasons why we have been labelled as the number one center in the world for keloid scars. You may want to begin by asking the countless patients who have had successful treatments with keloids as we have treated thousands, if not tens of thousands of keloids in the last decade. These patients have had their lives transformed.
Dr. Karamanoukian specializes in keloid scars and we can't begin to tell you how many patients travel from across the United States and even other countries to have their keloids treated in our center. Keloids take expertise to treat successfully and we have the lasers, technology, and clinical expertise to manage your keloids for good.
Our center has been a national center of excellence in keloid and scar treatments and our surgeon is double board certified. While actively engaging in clinical research, Dr. Karamanoukian offers comprehensive keloid treatments for all types of keloid growths on the face and body.
Our surgeon is a double board certified expert in keloid removal and treatment and the majority of our patients can be managed by non-surgical treatments.
Dr. Karamanoukian has been featured on The Doctors television show demonstrating his approach to keloid scars. With countless 5-Star reviews, Dr. Karamanoukian has established himself as a preeminent authority on keloid and hypertrophic scar management.
How can I get Dr. Karamanoukian to review my keloid case?
Our office receives many requests for keloid treatment from all over the United States and internationally. Clearly, we cannot accept every patient with a keloid problem because our treatments take time and patient compliance. We do not treat patients who believe surgery alone will treat their keloid as there is a regimented post-surgical regimen after surgery that minimizes recurrence. We would encourage you to contact our office and email photos if you are not local in Los Angeles. If we can help with your keloid, we may advise a surgical, non-surgical, or topical regimen for your keloids.
KELOID EXPERT IN BEVERLY HILLS / LOS ANGELES
Keloids represent a subset of scars that grow beyond the original footprint of skin injury. Most commonly associated with surgery, many keloids occur as a result of non-surgical skin injuries such as cystic acne, inflammation, and burns. Dr. Raffy Karamanoukian is a world-renowned expert in the management of keloids, having treated thousands of patients with his unique scar protocols that make use of technological advancements in lasers, RF radiofrequency, injection therapy, scar modulation, and fractional resurfacing.
Dr. Karamanoukian was featured on the popular television show, The Doctors, demonstrating his techniques for surgical keloid removal. In practice, Dr. Karamanoukian uses combination modalities that include kenalog IIT, scar modulation, laser therapy, RF therapy, and topical creams. Most patients begin treatment with daily application of Plato's Scar Serum in order to decrease keloid inflammation.
Plato's Scar Serum is a polysiloxane serum that can be used to massage into keloid scars in order to help modulate scar growth. Keloid therapy requires a multidisciplinary approach that may include lasers, injections, scar modulation techniques, and possibly surgery. A combination approach is the only way to reduce keloid growth and recurrence. Nonetheless, we do advise patients to begin Plato's Scar Serum even before coming into our office.
STARTING TREATMENT FOR KELOIDS
- SCHEDULE AN APPOINTMENT FOR EVALUATION (310) 998-5533: Not all keloids are managed the same. Some require surgical treatment while others worsen with surgery. Dr. Karamanoukian can evaluate your keloid and determine a proper protocol for you.
- TOPICAL SERUMS: Plato's Scar Serum should be applied vigorously on all keloids, twice daily. One tube provides enough serum for six weeks for a two inch scar. If your keloid is sebaceous or dark, we would advise additional topical creams.
- OCCLUSION: Scar strips are of limited use for dynamic scars, but provide some relief for static keloid scars.
- SURGERY VS. LASERS VS. KENALOG IIT: Every keloid scar demands a tailored approach. We would recommend a more individualized protocol for each patient based on skin color, skin type, keloid type, and location of the keloid.
Candela Vbeam Laser
Our plastic surgery office utilizes several lasers to help reduce scarring on the face and body. One of the most innovative treatments known for keloid scars and fresh plastic surgery scars is a laser known as the VBeam pulsed dye laser which targets the blood vessels that feed keloid scars. The laser is relatively painless and does not cause a lot of skin tissue trauma which makes it ideal for patients who want a non-surgical solution for their scars with minimal downtime. The Vbeam laser is available in our Santa Monica office and is ideal post-surgery for fresh incisions or for old scars.
Cutera Limelight
Some scars are extremely red, which is a sign of underlying hypervascularity and inflammation. Our office utilizes a Limelight treatment with broadband wavelengths to target pigmentation and redness associated with scars and keloids. If you have a lightly pigmented scar with underlying vascularity, this treatment can help reduce the redness and restore natural skin integrity.
Fractional CO2 laser
The fractional carbon dioxide laser is an excellent choice for laser assisted delivery of corticosteroids and for management of scar texture. We have used the fractional CO2 for over a decade and have found it to be very beneficial for patients seeking keloid management or for scar removal. In both cases, fractional carbon dioxide uses ablative energy to resurface the skin and obliterate textural details that make the scar visible. Dr. Karamanoukian developed the Sapphire Peel for patiens who may benefit from fractional ablative laser and chemical peels.
Morpheus8 RF
Once a keloid scar is reduced in volume, we continue to tackle the inflammation that causes scars to grow beyond their original footprint of injury. Keloid scars increase in volume and dimension over time. Morpheus8 is a radiofrequency treatment that is used to resurface and restore contour to deeply atrophic scars on the face and body. Keloid and hypertrophic scars can be treated by Morpheus8 once the inflammation has been reduced and the scar is no longer in its active phase of growth.
UNDERSTANDING YOUR KELOID
Myths about keloids
There are a lot of myths about keloid scars that make it hard to understand how to best treat your keloid. The fact of the matter is that not all keloids are the same. Some keloids develop as a result of surgery and tension on the skin, while other keloids are related to chronic inflammation related to sebaceous glands and sebum. We have found that it is very important to divide keloids into those that require surgery and those that will benefit only from lasers and injections.
Many people believe that keloid scars typically happen in darker skin types and Afro-caribbean ancestry. While we do see keloids in African American patients, keloids are not ethnically-selective and we commonly see patients of all skin types, including very fair Caucasian or Asian skin with keloids. Keloid risk is not clearly linked to ethnicity and skin color and we believe this is less fact and more myth. Our keloid demographic includes all ethnicities and is not exclusive to one skin type. If you have a family history of keloids, however, this may be something that runs in the family and may need to be explored if you are planning to do surgery.
Keloids require surgery: Myth or Reality
Because keloids can develop on any body part and can occur in men and women of any skin color, it is very hard to subdivide keloids into those that require surgery vs. those that do not. Dr. Raffy Karamanoukian will first need to analyze your keloids and determine whether surgery is needed or whether it is more effective to control sebum content and inflammation. This decision is based on years of clinical experience and can differ from person to person. In fact, a single patient with multiple keloids may have some that require surgery and some that would solely benefit from lasers or injections.
Once you read the information contained in our website, schedule a consultation with the world's leading expert in keloid management. Our protocols take time, but can significantly reduce keloid volume, keloid growth, and keloid recurrence.
