This is dr. Greg Chernoff, today we are going to perform an excision of this left ear keloid. You can see there’s an anterior component to it as well as a posterior component. Will be excising it with the carbon dioxide laser. Studies have shown that by utilizing the co2 laser to excise a keloid decreases the recurrence rate from near 100% to less than 5%. After we excise the keloid we’ll be injecting the keloid bed with some cortical steroid to decrease recurrence and we’re also utilizing today this placental tissue matrix you you’ll hear a lot about cellular regeneration, regenerative therapies. This placental tissue matrix will be injected into the periphery of the bed which will also decrease the rate of rate of recurrence so we’ll begin the game by prepping and then excising keloid. So, there we’ve removed a rather large keloid there’s the keloid bed that will be injecting the placental matrix into the periphery. We’ll now take off the posterior component. So, here we’re injecting some corticosteroids into both the anterior and posterior component of the the keloid bed and then we’ll be injecting. Now we’re injecting the placental tissue matrix into the wound as well. Again, this will promote healing it will act as a nice scaffold and hopefully also then prevent the recurrence of the keloid as well. So, we’ve excised the keloid with carbon dioxide laser, we have injected with corticosteroids and now we’re injecting with the placental tissue matrix. This will heal and over the course of the next several weeks with much less of a likelihood of recurrence.