Keloidal Scarring in Hard Palate Grafts

Hard palate grafts are a commonly accepted treatment for lower eyelid retraction and are typically associated with low complication rates. The authors present a case of bilateral keloidal scarring within hard palate grafts requiring surgical excision. A 72-year-old woman who had undergone bilateral hard palate grafts to her lower eyelids for lower eyelid retraction was referred for the evaluation of ocular irritation. She was diagnosed with bilateral hypertrophy of the grafts with secondary entropion. The grafts were excised; the pathology was consistent with keloidal scarring. To the authors' knowledge, there is no previously reported case of bilateral keloidal scarring in normal donor tissue, which required excision of the hard palate grafts. It is important for oculoplastic surgeons to be aware of this potential complication when considering, discussing, and consenting patients for eyelid reconstruction with hard palate grafting.