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PUNCH EXCISION for ICE PICKS

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#1 Maria

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Posted 16 June 2003 - 11:59 AM

I've just got home from a consultation with a plastic surgeon about this deep pit, ice-pick scar I have and really HATE. About 1, 5 year ago I went to a derm and she told me there was nothing she could do about it (she told me excision wouldn't work) and that I just had to live with it (easier to say than to do). She told me she could only "smooth the edges" and unfortunately I had laser done which made it even WORSE (btw ablative laser is a BIG NO-NO for ice-picks). I actually blame myself for this because I didn't know anything about laser at that time and I should have searched the Internet BEFORE I did this ](*,)

Anyway, the surgeon I spoke to today was SO NICE and told me it would be very easy to excise it (I belive he will do what is called a punch elevation). He said it would leave a small, thin scar which is totally leveled with the rest of the skin. I will have a couple of stiches for a week and if I wanted an even nicer scar I could use strips after the stiches are removed. He said there was no need for an inside stitch. I also asked him if this was a common procedure and if he had done it many times before. He just laughed (in a nice way) and said this was the easiest operation you could do and that excision is the first thing you learn as a surgeon. The excision will cost about $250.

I walked out of there a little shocked but VERY happy. After what the derm told me I didn't have much hope and now I was told it was easy to fix!? The only bad thing is that I have to wait two months but hey, if I've waited this long two months really are nothing! I trust this surgeon because he also works at a well known, reputable hospital (and he didn't have the $$ in his eyes :D) . HOWEVER, I will not truly believe anything before I actually see it.

I just wanted to share these positive news with you all. This board has helped me when I have been depressed and hopefully this will give you a little hope. If everything goes well I will post some before and after photos since I know it's very hard to find good ones on the Internet.

I think it's going to be a good summer after all :)/

#2 Maya

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Posted 16 June 2003 - 01:48 PM

That's great Maria. :D
Keep us posted.

#3 Maria

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Posted 16 June 2003 - 03:15 PM

U bet I will :D)

#4 LAET

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Posted 16 June 2003 - 09:58 PM

Cool Maria, hope it works out great!

#5 Myrl

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Posted 16 June 2003 - 10:13 PM

I am happy for you too, I too had the same thing with a scar left on my cheek which was not an ice pick scar, but a pit and the excision that you spoke of is really for ice pick scars, I finally got the thing removed, surgically and it turned out great and I quit thinking about it, only $250.00 is a really good price, it sounds like you came on another plastic surgeon who just likes to help people feel better about themselves.

#6 Maria

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Posted 17 June 2003 - 12:42 PM

Thank you guys! :D

Myrl,
Yes, he seemed to be such a nice and humane person, not what I expected a plastic surgeon to be...and yes, I also think it was a good price (actually it's 2000 crowns ~ $250, depending on the rate). In general procedures seem to be cheaper here than in US and UK, maybe you all should come to Scandinavia and get your scars fixed! :)

I'm glad the excision worked for you, I hope it will work for me too [-o<

#7 mynameis

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Posted 17 June 2003 - 01:40 PM

Good luck :)

#8 johnygudel

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Posted 18 June 2003 - 01:10 PM

What's the size of your scar Maria ?.

Johnny.

#9 Maria

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Posted 18 June 2003 - 03:47 PM

Johnny,
Pretty small, about 2*2 mm but it's deep, that's why they have to excise it.

#10 johnygudel

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Posted 18 June 2003 - 06:53 PM

Maria,

Thanks for the info. I've just had two excision this morning, but they are scalpel excision so I've had layered closures.

Johnny.

Johnny,
Pretty small, about 2*2 mm but it's deep, that's why they have to excise it.



#11 Maria

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Posted 19 June 2003 - 06:21 AM

Johnny,
what does 'scalpel excision' (scalpel instead of a punch?) and 'layered closures' mean? What type of scars did you have?

#12 johnygudel

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Posted 19 June 2003 - 08:58 AM

Maria,

It's just a term I think, my surgeon cut my face with a scalpel, a punch is using an instrument looks like a cookie cutter (round usually). The punch is moved back and forth just like cutting a cookie dough. A layered closure means there are stitches inside to support the skin. If not stitched inside the outside stitches have to much pressure, not good for handling skin tension. In your case maybe it's not needed. I have ice picks, one is like 3 mm by 2 mm, and the other one is like 5 mm x 5 mm. It costs me $800 for both of them.


Johnny,
what does 'scalpel excision' (scalpel instead of a punch?) and 'layered closures' mean? What type of scars did you have?



#13 Maria

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Posted 19 June 2003 - 01:19 PM

Ok, thanks Johnny!
I don't know if he will use a scalpel or a punch but I asked him specifically if an inside stitch was needed but he said it wasn't. I think it's because my scar is pretty small.

Btw, are you going to use strips after the stiches are removed?
Please keep us updated on your progress! I hope it works for you!!

#14 johnygudel

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Posted 19 June 2003 - 01:47 PM

Maria,

I had an excision before and it'd worked wonders. :)/ . I'll be using Steri Strips for a week (usually it falls off around this duration).


Ok, thanks Johnny!
I don't know if he will use a scalpel or a punch but I asked him specifically if an inside stitch was needed but he said it wasn't. I think it's because my scar is pretty small.

Btw, are you going to use strips after the stiches are removed?
Please keep us updated on your progress! I hope it works for you!!



#15 emit

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Posted 20 June 2003 - 12:30 AM

Hiya Maria and Johnny,

I have just seen a surgeon who claimed that excision will help my learger chicken pox scars. I wasn't interested in getting laser done, and he was pretty adamant that subcision wouldn't work and fillers would not either. So as a subsitute he offered excision of my larger chicken pox scars to leave me with thin line scars instead. Anything to get rid of these godawful indentations that are so deep.

Johnny, how was the procedure done - did the surgeon put you to sleep or were you just locally numbed. My surgeon also said that there would be no need for inside stiches, just three small sutures on the outer.

I'm seriously considering getting this done, at least to be rid of a few of my scars would be a wonderful thing.

I've had a good cry about it all the same, he really didn't tell me what I wanted to hear and that is that the scars can be removed. I suppose I was hoping for too much there. I'll be please with a flat linear scar anyways, but I do worry about something going wrong and them looking even worse. Is that possible ...

Good luck everyone with your scar treatments :D

#16 Maria

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Posted 20 June 2003 - 05:31 AM

Emit,

There's no need to put you to sleep, you will only have to be locally numbed. What's the size of your scars? I think they will only use an inside stitch if the scar is big and there's a risk that the scar will reopens. If you use strips after the stiches are removed I think the risk for reopening is minimal!

I understand that you worry about something going wrong and that the scar will be looking even worse, I do too since I had a bad experience with the laser :D . However, you always have to take a little risk no matter what you do and since excision is a simple procedure for a surgeon I'd say go for it! At least that's what I will do! :)

#17 johnygudel

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Posted 20 June 2003 - 07:57 AM

Emit,

I have chicken pox scars too but I don't want to fix them, they have regular shapes :) . Is your doctor a plastic surgeon ?. If you don't feel he answers all your concerns that get a second opinion. Excision is a local office procedure so no general anesthetic needed. The worst part is just the numbing the rest is a piece of cake. Could you be getting a punch excision like Maria so no inside stitches neeeded ?


Hiya Maria and Johnny,

I have just seen a surgeon who claimed that excision will help my learger chicken pox scars. I wasn't interested in getting laser done, and he was pretty adamant that subcision wouldn't work and fillers would not either. So as a subsitute he offered excision of my larger chicken pox scars to leave me with thin line scars instead. Anything to get rid of these godawful indentations that are so deep.

Johnny, how was the procedure done - did the surgeon put you to sleep or were you just locally numbed. My surgeon also said that there would be no need for inside stiches, just three small sutures on the outer.  

I'm seriously considering getting this done, at least to be rid of a few of my scars would be a wonderful thing.

I've had a good cry about it all the same, he really didn't tell me what I wanted to hear and that is that the scars can be removed. I suppose I was hoping for too much there. I'll be please with a flat linear scar anyways, but I do worry about something going wrong and them looking even worse. Is that possible ...

Good luck everyone with your scar treatments  :D



#18 Maria

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Posted 19 August 2003 - 04:24 AM

Ok, it has been two LONG months for me but today is finally the day for my excision. I've decided not to start a new thread because there are some background info here.

I'm getting a little nervous, I really hope this will work [-o< ...if it doesn't I honestly don't know what to do. I will post more when I get back home!

johnygudel, any updates??

#19 Maya

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Posted 19 August 2003 - 11:54 AM

Good luck Maria - hope it all works out well for you!!!!

#20 Maria

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Posted 19 August 2003 - 04:04 PM

I'm back, I think it all went well. The worst part was actually the numbing...it hurt, ouch!!...but after that I couldn't feel any pain. I could feel some pressure and before I knew it he started to stitch the wound. It was a bit unpleasant because I could feel my skin being "pulled" by the suture. The procedure only took 10 min including preparations. (Btw, he did a simple excision, not a elevation, I misunderstood him the first time). Oh, another thing, I was told to wash with chlor-hexidine twice before the procedure. This might not be necessary but it will minimize the risk of infection.

He used a scalpel and cut out 2-2.5 mm. Even though the actual pit was smaller he wanted to removed the whole scar (the laser made it look like a rolling scar with a pit in the center even though one needling session and Super Cop/TriReduction improved it some). He said that how much you cut out doesn't affect the final linear scar.

I asked him about the other punch methods and he said that they only do punch grafts when they can't stretch the skin enough to stitch it up. He also said that punch grafts leave worse scars than excised scars. I don't even think he performs punch elevation.

I also asked him why some excised scars reopen and he said this could happen if the patient has an 'atherom' under the pit. Otherwise it shouldn't happen. He also said that inside stitches are needed only for wider scars.

I'm going to remove the stitches on Monday, hopefully I can put all this behind me then [-o<

Feel free to ask me any questions!

P.S Thanks Maya! :D