case_images: PMC4782658_01
case_images: Preoperative view of reluctant chest keloid
case_images: abd-91-01-0103-g01.jpg
case_images: PMC4782658_01_abd-91-01-0103-g01.jpg
case_images: f1
case_images: On physical examination, a large 6(W) (x) 8(L) (x) 1.5cm (thick) epidermal mass was seen over the midline of his chest below the cartilago ensiformis (Figure 1).
case_images: IMAP Flap design during the excision
case_images: abd-91-01-0103-g02.jpg
case_images: PMC4782658_01_abd-91-01-0103-g02.jpg
case_images: f2
case_images: The patient underwent complete resection of the keloid (Figure 2).
case_images: IMAP Flap was rotated 180  with primary closure of the donor site
case_images: abd-91-01-0103-g03.jpg
case_images: PMC4782658_01_abd-91-01-0103-g03.jpg
case_images: f3
case_images: The donor site was closed directly, which releasing tension by subcutaneous and fascial sutures (Figure 3).Histological analysis revealed a typical keloid feature.
case_images: Follow up after postoperative radiotherapy
case_images: abd-91-01-0103-g04.jpg
case_images: PMC4782658_01_abd-91-01-0103-g04.jpg
case_images: f4
case_images: At his last follow-up (18 months later), he was asymptomatic and demonstrated no sign of keloids at the donor or recipient site (Figure 4).