Keloids that form after surgery represent more than just a cosmetic concern—they’re a complex medical challenge. For patients with high-risk profiles, standard post-operative care often falls short in preventing abnormal scar formation. That’s where Dr Salinda Johnson’s evidence-based keloid prevention protocols make a significant difference.
At the London Keloid Scar Clinic, we specialise not only in treating established keloid scars but also in preventing them from forming in the first place. Through decades of focused experience and clinical refinement, Dr Johnson has pioneered a structured and proactive system that has redefined how high-risk patients are managed before, during, and after surgery.
Why Post-Surgical Keloid Prevention Requires Specialised Care
Keloid formation after surgery doesn’t happen by accident. It results from a cascade of biological, genetic, and mechanical factors that standard care rarely addresses in full. These include:
- Genetic predisposition
- Skin type (especially Fitzpatrick IV–VI)
- High-tension closure sites (e.g. chest, shoulders, earlobes)
- Delayed wound healing or post-op complications
- Inadequate intraoperative and post-op prophylaxis
While traditional care may monitor these factors passively, Dr Johnson’s model intervenes at each stage with highly specific, tailored measures designed to disrupt the keloid pathway before it begins.
The 5-Step Prevention Model Developed by Dr Johnson
1. Risk Profiling Before Surgery
Every patient begins with a risk stratification appointment where we evaluate:
- Personal and family history of keloids
- Skin type and scarring tendencies
- Type and location of planned surgery
- Healing patterns from previous procedures
- Psychological and environmental stressors
This comprehensive review determines whether the patient requires a standard, enhanced, or intensive prevention protocol. These protocols are then fully explained, allowing patients to participate in planning.
2. Pre-Surgical Conditioning Protocols
For moderate to high-risk patients, the weeks leading up to surgery are critical. Dr Johnson may initiate:
- Nutritional optimisation (collagen synthesis, wound healing)
- Skin conditioning using medical-grade silicone or barrier-supporting agents
- Stress modulation strategies (as psychological stress can upregulate inflammatory cytokines)
- Pre-surgical steroid therapy (if appropriate)
These measures build the optimal foundation for smooth healing.
3. Intraoperative Techniques
During surgery, small details make a major difference. Dr Johnson trains and works with surgeons to ensure:
- Low-tension wound closure using multi-layered, buried sutures
- Atraumatic tissue handling to reduce inflammation
- Strategic incision placement that minimises mechanical stress
- Intraoperative prophylactic injections (e.g. corticosteroids or anti-VEGF agents)
In some cases, intraoperative application of silicone gel sheeting is pre-prepared to begin the moment surgery is complete.
4. Immediate Post-Op Intervention
Within 24–48 hours of surgery, our prevention team implements:
- Silicone dressing or custom pressure garments
- Follow-up steroid injections where appropriate
- Monitoring for early signs of inflammation, infection, or delayed healing
- Patient-guided wound care education with hands-on support
This phase is often the turning point for high-risk patients, where small proactive steps prevent irreversible scarring.
5. Long-Term Surveillance and Support
Keloid formation isn’t always immediate. Our surveillance continues for 6–12 months after surgery through:
- Monthly or bi-monthly check-ins (in-clinic or remote)
- Tapered prophylactic injections if needed
- Guidance on sun exposure, physical trauma, and tension reduction
- Prompt intervention if any hypertrophic or early keloid activity begins
This long-term approach dramatically reduces the chance of recurrence and ensures early correction.
Key Areas We Prevent Keloids Most Successfully
We specialise in high-risk anatomical zones where surgical scars frequently become keloids, including:
- Chest and sternum: Post-cardiac surgery or cosmetic procedures like breast augmentation
- Shoulders and upper back: From orthopaedic repair or trauma
- Neck and jawline: Common after thyroid surgery or lymph node removal
- Earlobes: After piercing or revision surgery
- Abdomen: Following C-sections or laparoscopic incisions
If your planned surgery involves one of these zones and you’ve had keloids before—or have a family history—we strongly recommend booking a keloid prevention consultation in advance. Visit our surgical keloid prevention page to learn more about how we personalise care for these areas.
Frequently Asked Questions: Post-Surgical Keloid Prevention
Can you prevent a keloid even if I’ve had one before?
Yes. In fact, prior keloid history is one of the strongest predictors, and it means you’re an ideal candidate for our intensive prevention programme. Our protocols are designed to break the repeat cycle of post-surgical recurrence.
Do I need to be a patient of your clinic for the surgery itself?
Not necessarily. Many patients undergo surgery elsewhere but come to us for the prevention phase. We liaise with your surgical team and coordinate timelines to ensure continuity of care before, during, and after the operation.
Is steroid injection the only option for prevention?
No. Steroids are just one tool. Our protocol may include silicone application, pressure therapy, nutritional optimisation, and (for specific cases) low-level laser therapy or immunomodulatory approaches.
What’s the success rate of your prevention protocols?
In high-risk patients, our tailored approach reduces post-surgical keloid formation by up to 94%—a significant improvement over standard care models.
What happens if a keloid still starts forming?
We act early. In many cases, early-stage treatment completely prevents the lesion from becoming a mature keloid. Our follow-up system is built around early intervention, not passive observation.
Next Steps: Plan Ahead with Our Prevention Clinic
If you’re planning surgery or have experienced keloid recurrence before, book a consultation with our prevention team. You don’t need to wait until a scar becomes a problem. Visit our consultation and treatment process page to see how we structure care and what to expect from your appointment.
For direct pricing information, view our quote request page or contact our team to discuss your options.
