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I am two weeks after excision. If was a relatively deep crater scar. I had an intradermal stitch as well as classical overlay 'micro' stitches. These will fade with time and I'm not worried about them. I had the stitches removed on friday and now I notice a slight depression along where the stitch was. It is still very red but I'm worried that the scar will remain indented, only before there was a crater shaped, now it's more linear.

However, the scar does look better, but not as good as I've hoped for. I was hoping for like 90% improvement but now (assuming it will remian like this) it's only like 50% improvement. I only had 1 scar excised because I want to see how it works out. If I like it, then I will have 12 scars excised in the future.

I'm starting massaging the scar tomorrow and aplying some ointments and silicone strips. But my question is for those who have had excision done before. Will the scar raise within the next 2-3 months? I know it will heal that long because the dr. said so and I've heard other's experiences as well. So, if I treat the scar optimally in the next weeks, can I hope it will level with surrounding skin?

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I am two weeks after excision. If was a relatively deep crater scar. I had an intradermal stitch as well as classical overlay 'micro' stitches. These will fade with time and I'm not worried about them. I had the stitches removed on friday and now I notice a slight depression along where the stitch was. It is still very red but I'm worried that the scar will remain indented, only before there was a crater shaped, now it's more linear.

However, the scar does look better, but not as good as I've hoped for.  I was hoping for like 90% improvement but now (assuming it will remian like this) it's only like 50% improvement.  I only had 1 scar excised because I want to see how it works out. If I like it, then I will have 12 scars excised in the future.

I'm starting massaging the scar tomorrow and aplying some ointments and silicone strips. But my question is for those who have had excision done before. Will the scar raise within the next 2-3 months? I know it will heal that long because the dr. said so and I've heard other's experiences as well. So, if I treat the scar optimally in the next weeks, can I hope it will level with surrounding skin?

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I've had excisions also. The indentations from the stitches goes away but I can't recall how long it takes. Did the stiches look almost too loose to hold the skin together? I had one come open slightly which is why I ask. I'm still spot treating that one. The excisions improved the icepick scars so I'm glad I had it done. Hang in there. smile.gif

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It was a local plastic surgeon. No one fancy. But excision is supposedly the most elementary procedure in plastics. The outer stitches are seen but they don't bother me - they will fade eventually or I will get them treated with Er:YAG local resurfacing. It's the linear indentation along the main stitch that worries me because it looks like - well a depressed scar, only finer and shallower. Simply put, I'm left with a red line and that line is a little depressed. So that's basically it.

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HopeEternal: That may be true as it was a pretty big scar in terms of depth and diameter. Well, I'll see in about 2 months how it turns out.

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Scar Revisions can only do so much with out a punch graft (at times). I have had multiple revisions done, but if there is significant fat loss under the revised scar, you will have a linear scar which will eventually appear much better, however, it may still looked slightly depressed due to fat loss.

This has been my situation on occasion and i have had 13 revisions.

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sharpeye: My scar was about 1 cm in diameter and pretty deep. It was the biggest scar on my face which is why I decided to fix it first. Because if this one works then others will too. I'm probably going to have revision on this one. And yes, it's true the scars take a significant amount of time to heal. But I don't want to sound negative. The scar has improved. It's a little longer but shallower and narrower. And it's only been less than 3 weeks. Maybe the surgeon didn't do it well but I still have faith that exision works.

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Should have used dermabond insted of stiches, or stiches for 2 days tops and then get them removed and put dermabond on. Thats what my doctor did, and I have absolutly no indintation.

Also the flatness of your scars will depend on how much fat you have in the surrounding skin, sorry to tell you but the less fat you have, the better exision will work.

I'm pretty skiny so my scars turned out flat since there was less fat in the surrounding tissue and thus ut was easier to fill in the whole with surrounding skin.

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sharpeye: My scar was about 1 cm in diameter and pretty deep. It was the biggest scar on my face which is why I decided to fix it first. Because if this one works then others will too. I'm probably going to have revision on this one. And yes, it's true the scars take a significant amount of time to heal. But I don't want to sound negative. The scar has improved. It's a little longer but shallower and narrower. And it's only been less than 3 weeks. Maybe the surgeon didn't do it well but I still have faith that exision works.

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I had an excision 3/05 -deep crater about 1cm also. The linear scar became indented and stayed indented and I've been trying to fix it since. I'm happy I did the excision--although it didn't end up a flat straight line. I've done spot CO2, spot Fraxel-6 treatments and PSR3 (5days ago) gradually,I have gained a great deal of improvement. Perhaps at 3-6 months you could have some resurfacing. I waited about 9 1/2 months. Ask your Dr.

Check out my recent (or past-if you want) posts.

Best of luck!

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If you had substantial fat loss under the skin, the excision will help but it may not erase the indention. I had a number of excisions done about 13 years ago and they helped quite a bit but I had to return with a filler for them to fill out or flatten out on the deepest scars.

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I recently put these questions to an online PS....

Question:

In my own experience and many others I have read, it seems acne scars often become depressed after surgical excision. Whether this is due to sub cuticular widening, inflammation or becoming bound down is unclear. What do you think? What incidence of this do you see, and do you take any special measures when excising acne scars. Thanks

Answer:

I think that is due to seperation of the tissues deep to the skin, especially common when many punch excisions are done and that creates more tension. In many cases the surgeon will not make the excision large enough and will not undemine the tissues and that aggravates the tension problem.

Question:

In regard to failed acne scar excisions you said "In many cases the surgeon...will not undemine the tissues and that aggravates the tension". What do you mean by undermining the tissues? Also, how long should the subcuticular sutures last? Thank you.

Answer:

Undermining is a technique that is used to lift and release the skin from the underlying tissues so it can be advanced toward the incision, allowing the skin to be closed without tension, in areas where numerous excisions are done one can at times not be able to undermine enough for fear of decreasing blood supply but if not enough undermining is done, then the tension is usually too great and although the skin can heal, the tissue below spreads and it appears depressed. The subcuticular sutures used should be ones that last at least 3 months.

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