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Unstable keloids are one of the most frustrating clinical problems in wound healing and the pathogeneses remains largely unknown. To date, little is known in the literature about the microsurgical management of unstable and middle-sized keloids on the trunk, and a clear consensus is lacking. Perforator flaps are thin and pliable, have a robust blood supply, potentially release the scar-site tension effectively and may provide an outcome with well-matched color, thickness, and texture. In this study, we provide a versatile algorithm by using various pedicled and free perforator flaps for the treatment of keloids on the trunk.

Abstract: Transgender Subcutaneous Mastectomy for Gender Affirmation: A Single Surgeon’s 5-Year Experience