Reconstructive & Microsurgery
Scar, burn & keloid care
Three related problems in wound healing — a scar that has healed badly, a burn that has contracted, a keloid that keeps recurring — each asking a different kind of care.
What it is
Scar revision aims to change how a scar matures, not simply to cut it out; tension across a healing wound is often what made it thick in the first place, so the plan usually addresses that as much as the scar itself.
Burn reconstruction deals with what a healed burn leaves behind — contracture limiting movement, loss of tissue, altered surface — through release, grafting and flap reconstruction.
A keloid is a distinct problem: scar tissue that keeps growing beyond the margin of the original wound, unlike an ordinary or even a raised scar that stays within it. It characteristically returns after being cut out on its own, so management is rarely a single step — it combines modalities chosen against how the keloid actually presents.
Provenance
Trained under Dr. Rei Ogawa
Dr. Cruz trained at Nippon Medical School under Dr. Rei Ogawa, whose work on scar and keloid management is internationally recognised — part of a year-long fellowship (2024–2025) spanning reconstructive surgery, microsurgery, keloid management and lymphedema. Cases are managed with a multidisciplinary team where appropriate.
For Keloids Specifically
Combining modalities
I
Steroid plasters & injections
Corticosteroid-impregnated silicone plasters and intralesional corticosteroid injections, often the first line for smaller or earlier keloids, usually paired with sustained pressure, as part of a multimodal steroid regimen.
II
Surgery
Surgical excision of the keloid; on its own it recurs frequently, which is why it is rarely used without a second modality alongside it, and the approach is planned case to case in consultation.
III
Laser
Laser treatment used to flatten a keloid and reduce its redness and texture, either alone for milder cases or layered with other modalities, chosen case to case in consultation.
IV
Radiotherapy
Low-dose adjuvant radiotherapy delivered after excision to reduce the chance of recurrence in keloids judged higher-risk, coordinated with a radiation oncology partner as part of a multidisciplinary treatment plan.
What is and is not known
No single treatment is guaranteed
Keloids are genuinely difficult to treat, and even a well-chosen combination of modalities carries a real chance of recurrence. Part of the consultation is being honest about that risk from the start, rather than promising a result no treatment can reliably guarantee.
Start to Finish
How it runs
I
Consultation
Assessment in person, a discussion of what is realistic, and a plan. Nothing is booked at the first visit unless you want it to be.
II
The procedure
Performed at St. Luke's Medical Center, BGC or Cardinal Santos Medical Center; duration and anaesthesia are prescribed on a case-to-case basis.
III
Early recovery
What to expect in the first week — dressings, swelling, activity limits, time off work — is reviewed individually before you leave the clinic.
IV
Follow-up
A follow-up schedule is set at your first post-operative visit, individualized to the procedure. For patients travelling from abroad, follow-up continues by video once you are home.
Candidacy for any procedure is determined at an in-person consultation, where anaesthesia, duration and recovery specifics are prescribed on a case-to-case basis. Not every procedure suits every patient.
Related
Complex Tissue Reconstruction
Microsurgical repair of larger defects
Read on
Regenerative technique
Biologic support for healing
Read on
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Dr. Pacifico Cruz
Board-certified plastic surgeon — reconstructive microsurgery and aesthetic facial rejuvenation.
Practice
Locations
St. Luke's Medical Center, BGC
Cardinal Santos Medical Center
Aesthetic Institute of the Philippines
© 2026 Dr. Pacifico Cruz, MD. Information on this site is for general purposes and does not constitute medical advice.
