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punch-techniques help

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what is the deal with this. every clinic I contact say that they don't do them, and the doctors I ask about it say that is is a very high risk procedure, and only suitable in extreme cases. I thought this was a commen procedure for acne scars...

Isn't it?

has anyone had it?

where did you have it?

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Before I came to these boards, I had 3 scars excised or punched by Dr Chris Zachary at UCSF in SF. Huge mistake, which I left to his expertise and judgement. In one case, he tried to excise a couple small scars with one incision. In another case, I had a small circular scar, which he converted to a smaller indented line scar. 2 of these 3 are now my 2 worst scars.

This last, small scar would have been ideal for a punch float because it was circular. Later, I also had 27 (counting redos) punch floats by Dr Y. Some of these (30%) turned out nicely, but most did not. Most that did not turn out well were really small scars on nose or around nose. I think you need a minimum size for this to work well.

Anyway, you will find lots of mixed reports on both these procedures, mostly because it is so crucially dependent on micro surgical expertise and your situation. That said, I believe the float or elevation technique is likely to lead to better results because you lift tissue, rather than excising it (which will no doubt leave an indent). Some of my floats did not get lifted level with surrounding skin, so it leaves a small circular mark/hole. But, as noted, some worked out very nicely.

It is wise to be cautious here, becasue you could make things worse.

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