Keloids: enigma of the plastic surgeon.

The treatment of keloids continues to be an enigma to the surgeon and the patient as well. There is to date no absolute single method that assures success. Generally speaking, we must use all the tools in our armamentarium, including radiation, intra-keloid steroids, surgery and postoperative constant wound pressure in an effort to remold the newly forming collagen. While these do not guarantee satisfactory results, they are the best we have to date and adequately justify our attempts to help patients with this problem. Of great importance is the necessity for the patient to be fully informed of the need for protracted follow-up without guarantees regarding the final outcome.