Your intuition is correct. Punch elevation pretty much only works on boxcar type scars that have a sudden, steep drop-off, but the bottom is actual smooth and "normal" appearing. Most chicken pox scars are like this. You'll notice that they they have have steep sides, but the center is smooth for the most part. Ice picks are completely scarred in the center, so there is no good skin to elevate.

I've done a decent amount of punch excisions for my deeper ice pick scars and the results are mixed. Some of them were made imperceptible, others widened and got deeper. A lot of it is technique, but it also has a lot to do with your physiology and your ability to heal. Some people just have a predisposition to scar badly.

Thanks for the explanation blahblah82!

That is what bothers me most about excision - you never know how its gonna turn out.

I will add that I've been to quite a few derms in the past couple of years, and almost all of them tried to talk me out of punch excisions and excisions in general. I think most feel that they do not work well and have the potential for worse scarring.

Your intuition is correct. Punch elevation pretty much only works on boxcar type scars that have a sudden, steep drop-off, but the bottom is actual smooth and "normal" appearing. Most chicken pox scars are like this. You'll notice that they they have have steep sides, but the center is smooth for the most part. Ice picks are completely scarred in the center, so there is no good skin to elevate.

I've done a decent amount of punch excisions for my deeper ice pick scars and the results are mixed. Some of them were made imperceptible, others widened and got deeper. A lot of it is technique, but it also has a lot to do with your physiology and your ability to heal. Some people just have a predisposition to scar badly.

hey blah blah what are you thoughts on punch excision for ice picks did you regret doing it anything you would change at all i have just had a consultation myself with a plastic surgeon about punch excision for ice picks considering going in for the procedure would appreciate your thoughts. Thanks

Its all about wound closure and the tension on it. There needs to be both an inner and outer stitch and the really good plastic surgeons will actually give you a little botox injection in the general area to paralyze your facial muscles to further minimize any tension, simple but kinda brilliant.

Its all about wound closure and the tension on it. There needs to be both an inner and outer stitch and the really good plastic surgeons will actually give you a little botox injection in the general area to paralyze your facial muscles to further minimize any tension, simple but kinda brilliant.

its not always possible to use a inner stitch like my ice picks are 1mm or 1.5 my ps said in order to put in the inner the scar must be at least 3mm i do agree with the botox may be a good idea

I had some excisions that turned out well, and others that were terrible. Excisions really should be reserved for the worst and deepest scars. I remember a girl who posted her experience on here years ago that had a ridiculous amount of excisions all over her cheeks and the end result was that it gave her a "quilted" pattern on her cheeks. Definitely not an improvement in my book. What I have observed is that by addressing the very ugliest scars, even though it may only be a few, really has a dramatic affect on how others perceive your scars / skin.

I had some excisions that turned out well, and others that were terrible. Excisions really should be reserved for the worst and deepest scars. I remember a girl who posted her experience on here years ago that had a ridiculous amount of excisions all over her cheeks and the end result was that it gave her a "quilted" pattern on her cheeks. Definitely not an improvement in my book. What I have observed is that by addressing the very ugliest scars, even though it may only be a few, really has a dramatic affect on how others perceive your scars / skin.

thanks for you insight was it punch excision was it by a derm or a plastic surgeon how big were the ones you got excised, any tips on how to prevent the wound pulling apart? i do agree with you regarding it cant be done on all over scars if you have alot but its just a few ice pick scars well spaced apart thats why i am going ahead to do it because can only be improved that way i will then be following up with dermbrasion and recell for my remaining scars this October.