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littlefrog75

Punch excisions?

I had several punch exicsions about four weeks ago....A couple of them turned out pretty good, but a couple of them as they have healed have become depressed again. The excision didn't come open or anything, the indent just seemed to gradually return as the swelling went down. I am kind of disappointed about this and am wondering if anyone that has had these done has had a similar experience. I would say that there's still about a 50% overall improvement in the ones that have re-intented but I had just expected to be left with a flat linear scar after this procedure, not these pits returning :(

I'm kind of stressing about this because I have an appointment in another week to have 3 more excisions done, but now I'm wondering if I should even bother if it's not really going to work.....

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Hi Littlefrog -

I had quite a few excisions done back around 1991. Some of them remained flat after the excision and others sank down a bit after the swelling went down. You may want to ask your derm but I think it is related to the loss of tissue under the skin. On the deeper scars, the substructure and fat is damaged so the skin will sink down a bit. At that time in 1991, there was no such thing as subscisions and the only filler was bovine collagen. Nowdays, subscisions and fillers are being used widely and the areas that sink down may respond to a subscision and a filler. However, I did notice that the excisions, even when they sank down, made the scars a bit shallower and narrower so it did help. If you are getting significant help on some of your scars, that sounds like good progress.

This year, I had subscisions followed with fat transfer - that helped because it released the skin that was bound down but I was too lean to get much fat. Next I did the subscisions again with fascian filler and that has seemed to help more in filling in the depressed areas.

Unfortunately for all of us on this forum, acne scars may require a combination of treatments and possibly some repeated treatments to make significant headway.

Dan T.

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Thanks for replying Dan....

I will have to ask my derm about the option of subsicion and/or fillers. It was pretty depressing to have the excisions look so good at first and then watch the scars gradually come back....but I'm not going to give up yet to find a way to improve these. Its good to know that I may have other options!

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