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havingfaith

Punch Floats

Dr Y is probably the most famous for this procedure. He is older now and will likely retire soon. I went to him early this year and had mixed success. About 25% to 30% turned out quite well, but the others saw no improvement, probably because the graft was pulled back down or fell out. Or, maybe he is losing his touch. He is a great guy. Also, it does leave a small mark, even if graft becomes level with skin.

In concept, this procedure makes great sense to me and he is known for his past success with this floats. I am surprised more cosmetic docs don't practice this tehnique.

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I had several small ice picks/scarred pores on/around nose. These did not turn out well, possilby because with my oily skin the floats/steristrips did not stay in place long enough to take. Or, maybe they were just too small to treat. I also had an excision that was screwed up terrribly by a previous doc, making a far worse, indented scar. Dr Y tried to pull this scar up with 2 floats. These also turned out poorly.

The scars that responded well tended to be circular, deeper and wider. I will call them box scars. Getting the elevation right is tough because even if the graft stays in place with steristrip, there is a tendency to shrink back a little. I would say all my scars have a flat surface, they are just indented. In any event, I would say I got a 90% improvement in the 25% to 30% that worked well. I had 4 Fraxels after this. In bad lighting I can see where these succesfully treated floated scars are, but I can't find them in good light.

I guess I am unusual in that I had a bad experience with excisions, which I attribute to a poor surgeon. Floats were a mixed bag. Fraxel was great for color, tone and texture, but I don't think I got much improvement in scars. Keep in mind that I am 55 and spend a lot of time at swimming pools or at beaches, so perhaps my fraxel results were hurt by sun exposure and age issues. Despite this, I would rate Fraxel as making my skin look better than excisions or floats.

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Dr Chris Zacahry at UCSF who has a big name for laser surgery at a prestigious med school. I think he got the great rep because of his charm (he is a Brit), teaching and research. He is no good in the surgical trenches.

I had three incisions. The first was an area with 3 small icepicks, which he decided to excise in 1 incision. He removed too much skin and my skin is really tight, without proper stitches. The tnesion caused the scar to separate, leaving a way worse indented line scar. Another turned out ok, but it was a nice circular, reasonably deep and wide scar. As I learned later, this would have been a perfect candidate for a float, as it was the type that got 90% improvement with floats. I'd say I got a 50% improvment with excision, as it too left an indent.

The last was a deep scar that had a cyst. He removed cyst, it returned so he excised again. Again, scar separated, so he excised again to make it tighter. With all these repeated, longer excisions, skin was removed, again leaving an indented line scar. We tried to float this but it did not work.

I am probably special case, but these three scars were my worst before and they are still my worst scars. Two look worse, one looks better than before.

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Question for billyboy or anyone who wants to answer - How big/wide does a roundish, fairly deep scar need to be to be a good candidate for a float as opposed to an excision? I am not sure what is most appropriate for me. I have two that are fairly close together at leat 2mm wide each. Thanks!

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I have not looked closely at my scaring in awhile, but the question prompted me to do so. My biggest float has a diamater of 2 maybe 3 mm. This is one where he tried to pull up the worst incision that separated, leaving a depression, and had several trimmings due to cyst. On closer inspection, I actually think the float probably made it look slightly worse, but I attribute this to trying to float scar tissue that was sunk. Again, I had several that turned out great.

I don't recall how small his punches go, but I think it is .5 mm, and that is the size he used on virtually all my floats.

On a positive note, it seems to me that there has been some filling in since my last close up inspection. I use reading glasses and the medicine cabinet mirror reflection onto main mirror at various angles to get a super close up view of indents. I guess it is true that collagne continues to remodel well after fraxels. I noticed the same thing with floats, they got better with time. At first, they looked pretty bad.

I would ask Dr Y for his thoughts. I know he feels he gets better results with floats than excisions. But others feel differently.

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Butterflies,

Sorry to hear the floats didn't work out. What part of the face were they floated?

Thanks. One on my chin and the rest on the cheek areas (both sides of face). I have an appt w/ a plastic surgeon on Monday to see if he'll fix 2 that really bother me. I'll keep you posted.

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