Keloid scars were once known as a plastic surgery nightmare, mainly because they are prone to recurrence after excision, and once they do recur they are often larger than the original lesion. The plastic surgeon would have finished removing the lesion, and the immediate surgical result would have been more satisfactory for both himself and the patient. However, after a few months, the scar gradually grows and is prone to cause dissatisfaction between the doctor and the patient. In the current medical environment, patient satisfaction may be more important than ever, and how to reduce recurrence is the current challenge for keloids. Ear keloids have the characteristic that what was originally a pierced ear turns out to be a bottomless pit, and the constant expense, effort, and treatment modalities invested make it difficult to achieve eradication. As I have seen more and more recurrent cases, I have summarized my comprehensive treatment approach, and the immediate surgical results will be basically satisfactory, with a significantly lower long-term recurrence rate than the currently reported efficacy, which is presented for your reference.