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Facial Plast Surg
DOI: 10.1055/a-2689-1591
Original Research

Effectiveness of Stellate Excision in Reducing Keloid Recurrence and Improving Aesthetic Outcomes in the Upper Third of the Ear

Authors

  • Francesco Di Pierro 

    1   Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy

  • Sean Bo Jie Loh 

    2   Yong Loo Ling School of Medicine, National University of Singapore, Singapore

  • Nevin Yi Meng Chua

    3   Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore

  • Ayman Alwyn D'Souza

    4   Hampshire Hospital Trust, NHS, UK

  • Chew Lip Ng 

    5   Department of Otolaryngology-Head and Neck Surgery, Ng Teng Fong General Hospital, Singapore
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Abstract

Aims and Background

Auricular keloids, particularly in the upper third of the ear, often recur after treatment and can cause aesthetic and functional deformities. This study assesses the effectiveness of stellate excision in reducing recurrence and improving cosmetic outcomes.

Historical Aspects

Stellate excisions evolved from 19th-century wedge excisions, refined by 1960s otoplasty techniques to preserve ear shape and prevent deformities. Traditional skin flap techniques frequently show high recurrence rates and can compromise auricular contour, leading to unsatisfactory results.

Anatomy

The ear, and specifically the upper third, is a challenging site for keloids due to its characteristic anatomy and susceptibility to mechanical stress during healing.

Technology

Stellate excision allows for precise resection of keloids with back cuts and wedge extension to preserve ear shape and reduce tension.

Patient Selection

Forty adult patients with upper third keloids were retrospectively studied. All underwent stellate excision and standardized steroid injection follow-up.

Techniques

Complete excision with cartilage wedge resection, local flap closure, and layered suturing was performed under local anesthesia.

Postoperative Care

Triamcinolone injections were administered at 2, 4, and 8 weeks postoperatively; follow-up continued for 24 months.

Current and Future Development

Stellate excision showed a 95% success rate; future studies should assess broader anatomical applicability.

Conclusion and Clinical Relevance

Stellate excision is a reliable and cosmetically favorable method for managing upper third ear keloids, with a low recurrence rate.

Keywords

stellate excision - keloid - auricle - recurrence - scar management


Publikationsverlauf

Eingereicht: 02. Juli 2025

Angenommen: 04. August 2025

Accepted Manuscript online:
25. August 2025

Artikel online veröffentlicht:
02. September 2025

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