This lovely young lady had a large persistent keloid scar of the right ear lobe. After multiple excisions elsewhere, the keloid became larger and larger. Dr. Brace used state of the art technology with a subtotal excision using CO2 laser, with laser ablation of the keloid base, and post-surgical medical management with injections and silicone sheeting to get the keloid scar to flatten and prevent recurrence. A staged procedure can be performed to further reduce the keloid utilizing CO2 laser to continue to refine and reduce the scar without risk of making the keloid larger.