I am a 45-year-old African American woman. I would like to have upper and lower blepharoplasty but I am concerned about scarring. I have a keloid scar on my arms for an older injury, and I am wondering if I might run the risk of getting keloids on my face from the incisions. What are your thoughts on this?

This is a common concern for darker skin patients wanting to have facial cosmetic surgery. While the risk is there it is a very small one. Just because you have keloids on your arms does not necessarily mean you will end up with keloids somewhere else. Skin from different parts of the face and body reacts differently to an injury. There are certain places such as the back, shoulders and arms that tend to keloid much more than other places mainly the face. Also, keloids tend to happen when there is excess tension when closing the wound. Upper blepharoplasty incision should be closed without any tension using meticulous wound closure technique. I personally have not seen keloid formation on upper blepharoplasty incision. For lower blepharoplasty, a transconjunctiva incision (incision inside the eyelid) could be used to prevent keloid formation.