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Under The Radar

Punch Elevation..........

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Hi guys.

I know there is a lot of talk throughout many of the forum posts about punch excision, but I find very little in the way of punch elevation.

I was hoping if anyone out there has any experience or thoughts on punch elevation if they could gladly share this information with me.

Am specifically curious with how the scar came out after the procedure, and whether improvement was gained, or whether it may just be another hit and miss type technique like many of the punch excision comments I have been reading.

Thanks a heap if anyone can help!

[Edited image out]

Edited by Vincci
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Hi under the radar,i'm also interested in this procedure but unfortunately like you im having difficulty finding out more about it,let alone find a derm/doc in the uk who does it! i believe it's one of the best treatment options for deep boxcar scarring,which is what i have,dnt know about you? where are you from btw?

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Yeah hi Bmarie81.... nah i'm not from UK but in Australia. I went to two derms recently and the second one suggested punch elevation, as he does not practice the excision procedure.

I'm not sure why there isn't too much info out there about this procedure, I don't want to rush into anything without first doing the homework myself.

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Hey again,you've most probably already seen it but there is a really good review on here about punch elevation or punch'floats',only problem is it's from 2003! To be honest though i think your best bet is to just go ahead & ask the derm that recommended it to you,after all if he performs it i'm pretty sure he'll fill you in with all the details.Just be sure to tell him you're keeping your options open & dont want to be rushed into anything.He should understand that if he's a good derm. My problem is just finding a derm that does it,it's even harder than finding info on the procedure itself! oh well.Keep us posted anyway :)

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i hear theres a dr chu in the uk who is a specialist with scars, you might try him. ive had punch elevations done in the USA. the thread from 2003 should be just as valid today and id use that as your guide. the procedure is done with a punch tool on icepick scars. this is a good procedure and works well but it's intended to be done before dermabrasion and thats key to the end result. otherwise you're better off with excisions or something like TCA cross or needling. ice picks are very difficult scars to treat. hope this helps.

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Thanks desim100. The derm did say that laser would be beneficial at some stage after the punch elevation, but this makes we curious as to what type of reaction the skin will have to this procedure.

Can you share any insights into whether your ice picks scars were too elevated after the elevation or what the actual outcome was from your experience? Did it create a raised scar and therefore laser or dermabrasion are necessary to smooth it out? Or did it just show a minimal elevation of the former scar and the scars depth only improved marginally?

Also did your skin recover fully from the suturing after the elevation, or was there some type of negative outcome?

Much appreciation for your assistance.

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under the radar, i dont visit the site regularly anymore and they've changed the layout and not for the better. if you can navigate your way through to the old posts from 2005 back you'll find tons of information on this. the information from back then seems to be lost nowadays and newer members have lots of questions that were answered a long time ago by people with lots of experience and sage advice. i believe most people move on once they get improvement they can live with and don't come back much.

here's some basics i can share with you:

the punch elevation (float) will bring the ice pick scar level with the surface but will leave a ring around it from the tool. the tool is the same as a punch tool used for excisions. what you will have with the finished elevation or float is a dot with a ring around it. there is no suture or stitch. these should cost you around $50-60 a float. i had well over 30 punch floats done followed by full face wire brush dermabrasion weeks later. i had a second dermabrasion a few years later but this time punch floats were unnecessary. ive also done TCA cross and professional dry needling on my icepicks that remain or were too small or still needed improving. tiny icepick scars cannot be floated and the smallest tool is 0.5 mm if i remember correctly. the dermabrasion will erase the ring left from the tool and smooth out the float. you didnt mention what laser you were having so i cannot comment on the effectiveness of laser following this as ive never had a laser procedure. following dermabrasion, as collagen rebuilds and you recover over the months, "bridging" will take place and the ring will fill in. not all your floats will "take" necessarily and some may open back up during dermabrasion for instance as a few of mine did. there was a gal on here years ago named misty who in her liftetime had 5 full face dermabrasions and i believe she had a follow up punch elevation or two without dermabrasion. her skin was very nice to begin with and she had what id call minimal scarring. she had good results from the elevations without the derm. so people do this but in my opinion and experience and the opinion and experience of my dermatologist, the follow up dermabrasion or laser will give you a better result in the end. i would be uncomfortable having strictly a punch elevation and would want to do a follow up treatment over it as i did. feel free to pm me if you have more questions as i do not check in here very often these days. i peek in from time to time to see if there are any new developments in scar treatments and recently wanted to learn more about dermarolling but havent learned that much yet. if you're fair skinned i personally wouldn't hesitate to recommend any of the procedures to you i've done and ive had no complications from any of them. needling and TCA cross are fine for multiple skin types but dermabrasion is best left to the fair skinned individual. hope this helps you some. good luck!

Edited by desim100
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I'd like to know more about punch floats, too! Has anyone here had them done, apart from CherrySoda08? Anyone in the UK or Europe?

It sounds like a very interesting treatment, but few people here (and few doctors) seem to be doing it. :/

I'm not even dreaming of finding any doctor performing it in Finland, but if it comes down to it, I could go to the UK to have it done in some years. But would like to know more!

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I have had punch elevations done in Paris a couple of years ago. I feel like it was the only thing that really made a difference for my scars. I must've done around 30-40 of them, so a lot, I guess (not all in one go, though). I was really scared they would fail or the wound would open up or something, but it honestly never happened at all. My doctor brushed it off when I voiced my fears about this, but turned out he was right.


All this being said, punch elevations work best for a very specific type of scar - the rounder, the better. I had one really deep chickenpox scar that was perfectly round, and after it was elevated it was gone completely. I can't even tell for sure where it used to be. Punch elevations sadly don't work at all on ice pick scarring, but if you mainly have round boxcars, it could be the way to go.

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@Gary_6100 Posts even a year old people seldom respond back to as they move on with their lives after treatment. That being said I have nightmare cases of people (many )who do punch float, excision, etc. It relies on you healing perfectly. This is a challenge for those with acne scars or they would not have scars to begin with. As it's surgical your surgeon must be very skilled (plastic surgeon's are best). I would never try this first we have things that work for scars without cutting them out of your face. The truth is any time we cut we can make another scar that "could look worse. The more of them you have to do - eg, all over your face, the worst it can turn out. If you have a few then sure it may be a option. IT's also the location that matters - certain anatomical markers would turn out poorly compared to others. I always suggest starting with manual methods that do not involve over invasive surgery first before considering cutting areas out of your face. If you want to learn more about the procedure checkout the FAQ pinned to the main scar treatments sub, then goto that section under excision. It has fallen out of favor in recent years with modern dermatologists not wanting to take the risk unless it's a single scar or two or geometric closure needed for a large area.

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