I know this might be stupid, but what is the punch float process exactly? I had a plastic surgeon talk to me about punch excisions.. which has stitches invloved after "punching" out the scar. I have an eyebrow peircing that never closed up I could do first to see how it looks though (punch excision).
I have schedualed dermabrasion with Dr. Y for Nov. 9. I don't think I could fly to New Orleans for both derm and punch floats so I want to know if I could deal with my icepicks before I go for dermabrasion.
Good luck Animegirl. What did Dr. Y think about you getting punches...
Punch Float Overview
I had 23 Punch Floats Done. 12 on the right side. 11 on the left side.
1. You arrive at the office, check in, fill out forms, etc. Bring a picture ID.
2. Cassandra calls you back, talks to you briefly and then you wait for Dr. Y.
3. Dr. Y comes in and you have your consult. He is a wonderful, warm, caring person. You immediately feel at ease around him. We talked about my scar revision history, I showed him pictures, we talked about the boards and then what to expect with the punch floats.
4. You are moved into the procedure room and asked to wash your face with a betadine solution. You are asked to wear the fashionable blue surgical cap and then they take pre-op photos.
5. Dr. Y applied alcohol to my face. He then made several injections with lidocaine into my right cheek. This is the most uncomfortable part of the entire procedure. It is not terrible, but it is unpleasant at times. Once the injection has been given the area is massaged for a moment and then he begins the punch float technique. He takes the instrument and removes the icepick very quickly. We had a minor glitch on the first one, the skin got stuck in the 1 mm punch and he had to put a stitch in the area, basically giving me a tiny excision. Once the icepick has been removed and the healthy skin "pulled" into place, Cassandra holds a piece of gauze to the area to stop the bleeding. He then moved to the left side and repeated the procedure. Once he had finished both sides he gave me the mirror to look at the areas prior to the tape being placed over them. They reminded me of tiny little pies all over my face. I know that sounds weird, but it was the way the little rim was around the new skin. We all had a laugh about that! : P
6. After he was finished Cassandra swabbed the area and applied the steri-strips for protection and to hold the new skin in place. They advised me to be very careful washing my face, showering, etc. I have just been washing around the areas with cotton balls or a q-tip. Dr. Y also said to blow dry the steri-strips if they get wet so they do not come off early. Of course you are not to peel or pull at the tape in any way. Once the strips fall off it is okay to wear makeup. I will remove the suture from the excision on Day 7.
**The size of my punches ranged from 1 mm (which is the smallest he does) to 2 1/2 mm.
The next post will answer you guys questions. 
Part Two
1. Best way to get rid of redmarks?
The use of a prescription bleach cream such as hydroquinone can be helpful, but sometimes time is the only thing that will help.
2. Well does he do spot treatment?
Yes.
3. Has he had anyone result with more scarring or negative results?
Yes, He has had two patients who ended up with infections post dermabrasion. One woman could not keep her hands off of her face and kept picking at the healing skin. The other lady applied makeup to her face 3 days after the dermabrasion for her flight home.
He stated there have been a few rare occasions where a person starts to develop a small hypertrophic scar. He stated that this can usually be remedy by the use of a cortisone impregnated tape strip that is applied to the face. He emphasized the likelihood of this happening was rare.
4. What does he think about dermabrasion being invasive or the last option for scarring?
Dr. Y stated he believes dermabrasion is the best treatment for acne scarring when done with a wire brush by a skilled physician.
5. What's the lightest or lowest setting dermabrasion can go?
The depth is determined by the physician performing the procedure. It can be done lightly or deeper depending on the severity of the scarring.
6. Would he consider some scarring too mild for dermabrasion?
He said that is really determine on a case by case basis. He said he will not do the procedure on someone if they have unrealistic expectations as far as outcome. Since dermabrasion can be used for skin rejuvenation, wrinkle reduction, etc., it can also be used to correct minor acne scars.
7. Um, one more can a very small hypertrophic scar be blended in with dermabrasion?
They do not routinely treat hypertrophic scarring with dermabrasion. If it is very tiny, I'm sure he could address that concern with you. I guess since one of the risks of dermabrasion is hypertrophic scarring, they don't want to take the chance.
8. If dermabrasion can be performed on a persons back/shoulders?
They do not recommend dermabrasion of the chest/back and/or shoulders. These areas do not heal as well as the face and often scar as a result of the procedure.
9. Tell him in the mid 1980s I sat in the University of New South Wales medical library reading an article of his when he was on the faculty of Tulane University which said early abrasion of surgical scars induces some as yet unknown mechanism which leads over a period of several months to the scars complete disappearance but when I eventually tried his theory some 10 years later it did not work for me. Why?
He stated a large part of the intended outcome depends on the method of dermabrasion used and the skill of the professional.
10. Is it bad if I used hydroquinone prior to considering dermabrasion, and do I have to stop using both retin-a and hydroquinone? You do not have to discontinue the use of these products prior to having a dermabrasion with Dr. Y. This is something you would need to discuss with whomever might be doing your procedure. Different doctors might have different protocols.
11. If you happen to not have left yet for your trip, could you also just confirm with him the average healing time and likelihood of hyperpigmentation or similar adverse effects (although I know it will vary based on skin type and from person-to-person)?
You can wear makeup by Day 10 and have healed quite well by the 2 week mark. The likelihood of hyperpigmentation increases with at risk skintone groups, but it really comes down to a person-to-person basis.
12. Does he know of any procedures to treat large thick raised scars on the face?
Sorry, I did not see your question before I left.
13. Also what does he think about derma being invasive or last resort?
I addressed this in a previous answer.
14. Does your face really look like that or are the pictures not capturing the scarring very well? You don't seem to have any indentations based on the picture. Were you wearing makeup?
Yes, my face really looks like this..lol. My scarring is very minor, (it better be after all of these procedures) and the icepicks were my major concern. No, I am not wearing makeup in these pictures.
15. What percentage TCA did you use on that scar BTW? Sorry for the questions, but I must know.
100% TCA was used on the area. You can read about that treatment Here.
16. I have the same pores, but they don't look bad on you. I can see some scars, but they look pretty mild. I'm confused as to how he determined what to punch.
I showed him my main areas of concern, then he marked them with a pen, I double checked them and Cassandra gave me the once over..lol. He said nothing can really be done to reduce pore size. He said they will temporarily look smaller after dermabrasion, but then they usually return to their normal size. I really didn't have a problem with them until the CO2 laser. I say problem, they really don't bother me that much.
17. I always imagined punch floats to be done on rather small crater type scars, but the scars in which you got them done appear to be scarred pores, small ones at that.
The areas punched ranged in size from 1 mm to 2 1/2 mm.
18. Animegirle, Did you get any opinions re: your pores from Dr. Yarborough? Did he say dermabrasion will reduce them? Did any of your other dermabrasions/co2 laser help with the pores? Do you think it's possible to punch float pores? Thanks.
Please read the above post regarding pore size. Dermabrasion never enlarged my pores, I had CO2 to thank for that. 
I think pores would be too shallow and the diameter too small to punch.
19. I know this might be stupid, but what is the punch float process exactly? I had a plastic surgeon talk to me about punch excisions.. which has stitches involved after "punching" out the scar. I have an eyebrow piercing that never closed up I could do first to see how it looks though (punch excision).
I have scheduled dermabrasion with Dr. Y for Nov. 9. I don't think I could fly to New Orleans for both derm and punch floats so I want to know if I could deal with my icepicks before I go for dermabrasion.
Good luck Animegirl. What did Dr. Y think about you getting punches...
Please read my previous post outlining the procedure. Dr. Y felt like I would be very pleased with the outcome of the punches. I sure hope so!
**Thanks for the comments on my eyes guys...lol. I really appreciate all of the well-wishes. I just hope the best for all of us.
Frances you have my number for sure...muahahahaha. 
Misty,
Thanks so much for sharing all the great info! I'll be doing a full face dermabrasion in late Dec.
Can you clarify who might benefit from punch floats?...You mention it can be done on scars as small as 1mm, but does that refer to depth or width? I didn't discuss punch floats at length with Dr. Y, he just said I didn't need them. My scars however are far worse than yours, and I really can't tell how the Dr. knew what areas to punch float...I certainly don't see any icepicks. I think you look great in your before pictures, in fact I wouldn't be doing dermabrasion if my skin looked as great as yours.
Anyway, thanks for your input! Healthy healing, and keep us posted! 
I want to take just a minute to say a few things about my scars. I know to a lot of you my scarring appears minor or non-existent. I realize I do not have severe scarring, but also realize I have been working at this for almost 15 years. That is a very long time and it does impact you to some degree psychologically. I also came from a household where perfection was demanded of you and you were belittled if you fell below a certain standard. I have worked very hard for many years to shake those demons. I fail at times because I am human. I desperately wanted these ice picks treated, not because I am looking for perfection. I am looking for improvement so my daily life is not so severely impacted by my perception of the scars. I go out and function in daily life, but this always is hanging in the back of my mind. It is not a quest for vanity; I just want to walk out of the house and not feel like a monster every time I catch a glimpse of myself in the mirror.
^I agree. Although some people have more or worse scars, who are we to judge how someone's scars affect them? Some people have a face full of them, and are blissfully unaffected, while someone else has a few and are devastated. It is all
relative.
It is nice for people to compliment others and reassure them it isn't bad. I do this as well, but it normally doesn't work.
I hear people trying to console by saying, "other's don't see you the way you see yourself," but I'm not bothered with what others think. I'm not looking to rid myself of my skin maladies to get a guy, or acceptance. I just want to be satisfied with the way I view myself on the outside. I don't need perfection, but I'll know my perfection when I see it.
Good luck, Misty. You have been working and suffering for a long time. I hope you can rest when this is done.