A 12-year-old girl with a history of prominent ears was treated by otoplasty at 8 years of age.
In both ears a keloid progressively developed from the year of the intervention.
The burn wound was located in the upper edge and posterior aspect of the upper poles.
The right had a horizontal size of 3.2 cm and vertical size of 2 cm, and the left 2.7 cm x 1.5 cm respectively.
The patient reported no pain or pruritus.
Resection was indicated given the large size of the lesions, with aesthetic and psychological repercussions.
The intervention was performed under general anesthesia.
The surgical treatment consisted of the following technique: an incision was made in the face superior to the keloid, from which a thin flap was dissected from the cheloid anterior skin, keeping the skin covered or normal.
After lifting the flap of an adequate size, the rest of the keloid was removed.
The flap was sutured to the defect without tension.
The size of the flaps was 2.5 cm x 1.5 cm in the right ear, and 2 cm x 1 cm in the left ear.
The anatomopathological study showed that keloid nodules were coated by epidermis and cutaneous adnexa.
Surgery was associated with other treatments, commonly used to prevent recurrence: intraoperative corticosteroid injection (acceptance of a silicone trichleate injection), and surgical bed closure of the resulting silicone gel, applied to the plastic dressing.
Silicone gel and pre-therapy were used for one year after the intervention.
The patient was periodically monitored.
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The right ear flap presented a small dehiscence of suture, which was treated by second intention a few weeks later with topical treatment.
No necrosis or other complications developed.
A satisfactory repair of the defects was achieved with restitution of the normal contour of the ears.
In the right ear, a recurrence developed 5 years after surgery, forming a keloid in the operated area of 1.5 cm x 1 cm, which was treated with the same surgical procedure.
There was no recurrence in the left ear.
At 18 years of age, both ears show good appearance and the patient undergoes regular check-ups
