Hiding in shame:
A 23 year old unemployed young man came referred by another doctor to my clinic 4 years ago. He was swathed in a white robe, his face all but covered. there was a fainit odor of an infection when he entered.
when he removed his head cover, i could see multiple objects handiing from the ears, jawline, neck and chin. most of them were the size and color of an eggplant vegetable. Some of these had ulcers on them and were infected. He was in some pain. He said that he is unable to face the world with such a grotesque appearance. He was mostly hiding in his house and had restricted social interactions. A prisoner in his own home!
These were keloids and they were of spontaneous variety, i.e there was no injury preceding these except for minor pimples. I assessed him for surgery and decided to do it in two stages. When he heard that they can be removed, his transformation was dramatic. He saw new hope. I had to warn him of the high chance of recurrence and the fact that he has to comply with after-care instructions.
After 2 months [the time it took for him to arrange the finances] he was admitted for surgery. I could remove most of the lumps completley and was able to advance local skin from the neck to restore the ear and jawline. i injected the margins with kenacort – a type of local steroid that helps to curb the re-growth of the keloid. His face was more human again.
The next day he was up, chatting with friends and staff and had discarded the hood completley. He was not bothered even about the scars of surgery. He came for the next stage of corrections and refinements in 3 months. While some early recurrence was noted [he did not keep up the followup sterioid injection protocol] the overall benefit was obvious in his confident manner.
This was a case of keloid which created “cosmetic” problems; but the deformity was so severe as to make him a recluse.
Plastic surgery sor such cases is not merely “cosmetic” but life changing.