Some patients claim to be keloid and mistakenly mistake proliferative keloid scars for keloids. In fact, if the hyperplastic lesion is confined within the injury area, we call it a hyperplastic scar; on the contrary, if the hyperplastic lesion exceeds the original injury area, has a tendency to “tumor-like growth”, recurs easily after excision, or even forms a scar far beyond the pre-surgical area, we call it a keloid. Such scarred lesions are called keloid scars. Keloid scars are a major challenge in the field of plastic surgery, and despite years of effort, it should be noted that the overall treatment results are not ideal. There are significant individual differences in the occurrence of keloids. The onset of keloid scarring usually appears about 1 year after the local injury. Causes include incisions from surgical procedures, trauma, tattoos, burns, injections, animal bites, needle marks from ear piercings, vaccinations, acne or foreign bodies in the skin, etc. In my outpatient practice, I have even found a limited number of patients who simply cannot remember any primary medical history and inexplicably develop annoying keloids on certain parts of their bodies. The clinical manifestations of keloid scars vary widely, generally presenting as a persistent lump that grows above the surrounding normal skin, beyond the original injury site, and is hard to the touch, with poor elasticity and localized itching and pain, especially when exposed to heat or alcohol. There are significant differences between keloid scars and common hyperplastic scars. Let us discuss the preferred sites of keloid scarring. The most common sites for keloid scars are the anterior chest, the back of the shoulder, the outer part of the upper arm, the earlobe, and the chin. Some areas, such as the eyelids, forehead, external genitalia, palms and soles of the feet, are rarely affected by keloids, but this is not absolute.