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First off, I am not calling anyone a liar. I have never seen a successful excision scar only dozens of failed attempts. I asked to see photos for my own knowledge and seeing that you have dozens of before photos already posted I think seeing the after would demonstrate success.
Dr Rappaport may very well still advertise punch excision on his website but, I have been to him for treatment on 2 occasions and he will not perform it on anyone. He is capable and has the tools but, prefers several other methods like tca, subscision and lazer for icepicks than punch excision. His words were " I will not do it. I see no sense in trading one scar for another". While I don't agree with him, I did use him for my icepicks and TCA is effective in helping to minimize the scar but, not remove it.
1 month update:
2 of my 12 excised scars look worse and larger - because they re-opened (no bleeding though) - all the other 10 look better - 2-3 of them look 90% improved (just small red marks) the other 6-7 look between 40 and 60% better.
Overall, I am still pleased - it's much easier to see the improvements when I have some concealer/powder on (since the red marks make me look like I am breaking out).
I really want to suggest to Dr Chu to do the double layer stitch - especially for the larger diameter ice picks - as the 2 that re-opened were the big ones in the first place.
I am going for excision next week. I have a chicken pox scar on my forehead (about 4-5mm in diameter) that I am going to get removed. I have seen three different plastic surgeons, and all of them have told me that excision would be the best option. I will make sure to write down my results here on the Board, so that people can decide whether they would like to get it done as well.
For those of you who have had excision, do you have suggestions or recommendations for things that I should do before, and after the surgery? Thanks.
Info about 2 layer stitches:
I spoke with a medical aesthetician today and she said that a 2 layer stitch is more effective because the skin would try and heal itself faster when trying to dissolve the inner stiches.
I hope Dr Chu will be able to do this for me next time.
I read once about a plastic surgeon who would surgically remove scars bit by bit. By this I mean he would excise a small portion of the scar, let it heal for about a month, and then go after it again repeatedly until it was completely removed. Accordingly, I don't understand why this couldn't be done with icepick scars, leaving a smaller scar. It just seems odd that you have to trade a deep circular scar for a longer straight one. I'll try to find the link again.
shiny,
I'm glad if I can help anyone by sharing my experience. If you pm me I'll give you my surgeon's details. However I really do think you can find a good surgeon in your country. This is such a simple procedure and any plastic surgeon should know how to do it.
jeanzz,
Please read the whole thread, there are a lot of useful info here. There will always be a risk of infection as with all wounds and you will have a small linear scar instead of a pit. In my case I can't really see the linear scar, it's so tiny. I paid ~ $250 for my excision. I suggest you to go to a plastic surgeon since they often are the most experienced.
nottoobad,
I never thought you were calling me a liar 
). I'm not sure who you were referring to having dozens of before photos already posted but I will post my photos here pretty soon I hope.
Homer,
I was told to wash twice with chlor-hexidine before the procedure. This will minimize the risk of infection. Don't take aspirin or anything that contains acetylsalicylic acid three weeks prior and 10 days after the surgery. About supplements I suggest you to at least eat zinc. And DON'T smoke, this is very important!
I had more excision today - received 8 stitches in all:
2 stitches on left cheek - a deep boxscar, and 6 stitches on my right, which covered two large scars together (he punched the whole thing together - it's around 1 inch long!!) - The whole procedure took around 25 minutes.
I asked Dr Chu about double layer stitches and he is still against them, said that the stitches that dissolve often cause inflammation and leaves a raised scar.
Update on my 12 excisions 5 weeks ago : 2 re-opened and look worse/larger now (Dr Chu said that this means it was under punched and won't be able to do these ones again for a couple of months until they are healed) The other 10 are all definate improvements, still look red, but with concealer, they are almost flat..... 4 of them are totally flat/gone for good and 6 are slightly indented, but looking better each day.
I asked Dr Chu about recommended aftercare - he said the do nothing method is good and doesn't recommend any AHAs for 3 weeks. I bought some 18% active manuka wound healing gel and am applying that over the scars to keep them moist and protected.
On the two stitch scar, he said to take the stitches out after 4 days, on the 6 stitch scar, he said to take 3 alternate out after 4 days and the other 3 stitches on day 7 (to stop the risk of it re-opening)
Dr Chu will perform more excisions in 3 months, he wants my face to heal up properly before doing more work.
I also received an NLite treatment at setting 3.
Rock - NLite helps with collagen growth, not red marks - and since excised scars can sometimes still remain slightly indented, the NLite is very useful (but in no way essential)..
The red marks for the excisions 5 weeks ago have faded so much - I put that down to the following:
Dabbing diluted Vinegar in the morning
10% Mandelic acid serum daily at night
Lactic peels once a week
And also the home made cream with ALA/DMAE/Q0_Q10, Emu oil etc..
and of late, the intense gel from puredeeming
Also, 4 days into the last lot of excisions, the skin has healed a lot quicker this time since I am keeping the excised areas totally moist by applying a thick film of Comvita 18% manuka honey gel on it all day (much easier to keep it on if you stick a plaster over it.)
hey dudes i want to remind you all that i would try excision this december on a 2 layer stich...My plastic surgeon is 73 years old and 40+ years experience in plastic surgery...These will be a 2 layer stich.....I will update as soon as possible...By the doctor's marked pen the size is about 7 mm(actually the scar is only 4 mm)on excision...
hi i am 30 years old...I have done blepharoplasty(lower eyelid) on eyebugs last june, well the thin scars(from operation) are hardly noticesable..Also have done excision on a back(cyst) about 7mm, i have seen a thin line also hardly noticesable...
I have talk to my plastic about a 1 layer stich, he refuse to do it coz in his 40+ years of experience some scars sunk back while other stich reopen(not good)...If the scars will turn-up to raised scars i think silicon gel sheets will be the answer...imagine your indented scars will raise sounds good coz no more depression
Jonah - Glad you found us! Welcome!
It's been around 6 weeks since my first set of excisions, the marks are now pink, not red - I think Lonelyman is right, it will take around 3 monhs for the redness to fade completely.
Personally, I don't think excision is suitable for tiny ice picks - since it does leave a longer scar (it's a fine line and sometimes still indented) - you got to bear in mind that the scar needs to be punch ENLARGED in order to sew it up. It's obviously very suitable for large ice picks and large boxscars) where a long line is still way better than a large hole.
My boxcscars/picks were 3-7mm long, they are worth excision. Smaller than 3mm, I'm afraid people won't like the results. I have some tiny ice picks - I will not be getting these excised - I think subcision/needling will e better.
I took some stitches out last night as Dr Chu suggested, this time, the healing was much better/less red - I put it down to:
1. keeping the wound moist with honey
2. NOT using the suoer CP serum which caused inflammation under the scars last time.
One of my scars is about 3mmx2mm, the most prominent one. But most tend to be less than 2mm, most are about 1mm x .5mm, u know, sort of long and thin. I guess that doesnt sound too bad, but I dont consider these tiny, and they are very noticeable. Since they tend to be shaped sort of like footballs i guess, i figured if i could just get them closed they'd look a lot better. But I had an impression the increase in length of the scar would be slight, if it's a lot i guess id have to reconsider. About how much longer are the excision scars than the original? Thanks a lot!
Also maya, i forgot to congratulate you on the results of your excision. They sound satifactory to say the least! =D>
Thanks Jonah - yes, I am pleased with the improvements through excision, although I need to give it a little more time to see final results - they will never be 'perfect' but I realised that - I can live with a few scars here and there but the ones that were most damaging to self esteem were right in the middle of my cheeks which are hard to hide.
I would say that a 3mm excised scar could leave you with a line twice as long (in my case at least) - the weird thing is, it's not the scar that seems to be leaving the line mark,... but the thread as it digs/cuts into the skin. Maybe it's different for others.
They can't sew too close to the scar (or the thread may pull into the scar), they sew on either side - so imagine the shape of a cross. It all fades eventually though and still looks better than a large hole.
I think you should check some of denise's posts on skin needling followed by CP and Retin-a (as long as you are not dark/asian skinned)
vaudor - Sorry, I didn't say to stop using CP on surgery scars - in fact, the standard CP serum seems very good after surgery - it's just that the SUPER CP serum has salicylic acid in it, and it seems that I am intollerant to it (as are some asian/darker skins - not sure why)... in the same way as my skin does not tolerate glycolic well (apparently this again is true of asian skins which are more sensitive/thinner)
The super CP caused inflammation under my scars but it seems to have helped many, especially denise (check skin needling thread).
Dr Chu told me no AHAs (like mandelic) for 2-3 weeks - so I am not using anything on the excised scars apart from the Manuka honey gel (very antibacterial and keeps the wound moist) - the rest of the stitches are coming out tonight and I will continue to use the honey for another couple of days.
After this, I will just use moisteriser like emu oil on them and probably put the ALA gel by puredeeming (note Alpha lipoic acid thread) on them (and rest of skin).. after another week or so I will start the mandelic acid and lactic peels.
The ALA gel by puredeeming has vit C in it.. and you can't use copper peptides at the same time (or within 12 hours) as they wipe each other out.. so I think I will go with the Vit C this time and see how it goes.
Hope that helps.