Tehran University of Medical Sciences (TUMS) Academic Journal of Surgery 2423-3218 8 1 2025 04 25 14 17 Ahmadreza Taheri Department of Plastic and Reconstructive Surgeon, Tehran University of Medical Science, Tehran, Iran hojjat molaei plastic &reconstructive surgery department, medicine faculty, Tehran University of Medical Sciences 2024 11 12 Background: Keloids are troublesome for both patients and surgeons who encounter recurrent lesions. Patients often seek newly developed treatments in hopes of alleviating the pain and manifestations associated with this condition. Surgery alone is generally ineffective and requires adjuvant therapies, one of which may be brachytherapy. Case presentation: We introduced a modification in catheter placement following surgical excision of keloids. In the two presented cases, after lesion removal and closure of the deep cavity up to the subcutaneous tissue, the wound margins were closed while leaving a limited route for the catheter to prevent its displacement. The skin was then closed. The results of immediate post-surgical brachytherapy for keloids were highly encouraging. Conclusions: Brachytherapy following surgical keloid excision yields significant results. This combination needs more concise catheter inset especially in subcutaneous field. https://ajs.tums.ac.ir/index.php/ajs/article/view/285