European Journal of Plastic Surgery

, Volume 41, Issue 2, pp 233–238 | Cite as

Intralesional excision combined with intralesional cryosurgery for the treatment of oversized and therapy-resistant keloids of the neck and ears

  • Lior Har-Shai
  • Norbert Pallua
  • Justinas Grasys
  • Issa Metanes
  • Yaron Har-Shai
Ideas and Innovations


This prospective case study presents a new method for the treatment of oversized and therapy-resistant keloids of the neck and ears employing intralesional excision combined with intralesional cryosurgery. The keloids were excised in an intralesional approach, and the remaining base and lateral margins of the scar tissue were frozen using intralesional cryoneedles. After complete thawing of the frozen tissues, the margins of the scar were approximated and sutured. The follow-up period extended over 18–24 months. Over a period of 12 months, the scars gradually flattened with no hypopigmentation. No signs of recurrence of the keloids were seen. Intralesional excision of oversized and therapy-resistant keloids combined with intralesional cryosurgery could well be an additional tool to the plastic surgical armamentarium, for treating this group of patients.

Level of Evidence: Level IV, therapeutic study.


Oversized keloid scar Therapy-resistant keloids Intralesional scar excision Intralesional cryosurgery 



The authors extend their appreciation to Professor Emeritus B. Hirshowitz, FRCS, for his valuable help in editing this manuscript for publication.

Compliance with ethical standards



Conflict of interest

The Author Y. Har-Shai has a financial interest in the Intralesional Cryosurgery technology. L. Har-Shai, N. Pallua, J. Grasysa, and I. Metanes declare that they have no conflict of interest.

Patient consent

Patients provided written consent for the use of their images.

Ethical approval

The intralesional cryosurgery treatments are approved by the Medical Devices Department (Registered Number 2800-0000), Health Technology and Infrastructure Administration, Israel Ministry of Health, and the CE marking (CE 0473).

Informed consent

The parents of the patients or the patients themselves signed an informed consent prior to the combined treatment.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Lior Har-Shai
    • 1
  • Norbert Pallua
    • 2
  • Justinas Grasys
    • 2
  • Issa Metanes
    • 1
    • 3
  • Yaron Har-Shai
    • 1
    • 3
  1. 1.The Bruce Rappaport Faculty of MedicineTechnion-Israel Institute of TechnologyHaifaIsrael
  2. 2.Department of Plastic Surgery, Hand Surgery, Burn CenterRWTH University Hospital AachenAachenGermany
  3. 3.The Unit of Plastic SurgeryCarmel Medical CenterHaifaIsrael

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