Reviews
3.4
30 Reviews
Good or Excellent Response
73%
Based on All Available Studies
Strength of Evidence
1
2
3
4
5
Moderate Response
100%
Based on All Available Studies
Strength of Evidence
1
2
3
4
5
Side Effects
Medium
How to Get It
Have a dermatologist or plastic surgeon? Make an appointment to get this procedure done.

Don't have a dermatologist or a plastic surgeon? See The American Academy of Dermatology Physician Database to find a dermatologist or the American Society of Plastic Surgeons to find a plastic surgeon.
Read All About Punch Techniques
5
33.3%
4
20%
3
20%
2
10%
1
16.7%

Used Punch Techniques? Rate It:

Choose from 1 to 5 stars
February 25, 2016
Punch Elevation
I had 8 punch elevations done about 5 months ago. I am extremely happy with the results. Five were done on my forehead, a couple right next to my nose, and one on my cheek. These were done on deeper scars left from cystic acne (I believe they were boxcar scars). The procedure itself was quick and fairly painless - the only painful part was the numbing injections. I had stitches in for a week, so I didn't leave the house much during that time. Once the stitches were out, the remaining scars were just a bit red, but otherwise fully closed up and I had no issue covering them with makeup. Basically, I ended up with smaller, flatter scars that replaced the deep, indented scars. In fact, a couple of the punch elevation scars on my forehead have since disappeared completely. My doctor recommended doing laser after the punch elevations to smooth over what is left of the punch scars and to help the rest of my acne scarring (just had my first session a couple days ago). All in all, I'm super happy with the results. Instead of a few deep indentations in my forehead, I'm left with just a couple of barely noticeable scars. Hopefully the laser takes care of what is left.
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Anonymous
April 12, 2012

Pros:

somewhat decent improvement in my scarring.

Cons:

not the right procedure for my situation.

what i didn't know at the time, and apparently, my dermatologist didn't know either, is that punch excision is ONLY to be used on boxcars that are *3mms or LESS*. mine was *4mms* -- a full 2 sizes larger than the 3mm maximum (as per virtually every single board certified facial plastic surgeon on the planet). . therefore, due to too much tension on the wound, my incision widened, leaving an even larger scar, slightly indented, with two bumps and a few shallow-moderate depth icepicks where the stitches had been (as he also apparently didn't know that stitches on the cheek shouldn't be left in for five days). a few months later, i had the area treated with an ablative co2 laser -- it eliminated two of the three icepicks, and smoothed out the area somewhat. i'm now looking into having dermabrasion for the bumps and further smoothing, and a dermal filler for the remaining indentation... so much for the "fine line" he said i'd have -- if i'm lucky, with the above additional procedures and time, the final result will be a circular scar almost twice the size of the boxcar (which was very deep, btw), but virtually flat and able to be concealed well with makeup -- an overall improvement of about 75-80%...not bad. but it's so upsetting that i could have had excellent chances at an even better outcome from the beginning with a scalpel incision, if i'd simply gone to the right doctor. please, please don't make the same mistake i did...sure, dermatologists may be cheaper, but this is your *face* we're talking about. see a BOARD CERTIFIED FACIAL PLASTIC SURGEON.
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June 23, 2016
how do you find out how deep your scars are. I think I have boxcar scars and am worried i'll pick the wrong treatment.
Woman of Color
December 7, 2011

Pros:

nothing

Cons:

Made scar worse

I had this procedure done almost 2 years ago from a derm office. I was reluctant so the doc offered me 1 punch treatment for 1 indented acne scar. I paid $250 for nothing. First off the stiches made additional scar areas on my face. 2 years later, the original scar is wider and I have 2 small additional indentations from where the stitches were. I would not recommend this treatment for everyone.
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Zellie
October 9, 2008

Pros:

I think punch grafts are the only way to go for very deep and pitted scars.

I had 12 punch grafts in Aug. 08. They look like darker bumps, but i was told dermabrasion, or laser will take care of that to smooth out the grafts/color. I'm going to have more grafts. Just changed Doc's, will let u know of results, but i can say i'm happy 12 holes are gone. $250./ per scar/graft. Tried 3 other treatments for acne scars, but no improvement for deep pitted scars.
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Sarah
April 14, 2008

Cons:

I had a Punch Biopsy done and it cost $250, took forever to heal and now looks no better than it did before the procedure. Obviously my plastic surgeon is a prick!

Wouldn't do it again. I have very fair skin that damages easily, so if you do as well I'd hold off on this procedure. Get a second opinion!
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ScarsNoMore
July 6, 2007

Pros:

Affordable; healing only takes about 10 days before makeup can be worn.

Cons:

Difficult to find a reputable doctor who performs the procedure; improvement difficult to predict.

I had three scars punch floated with Dr. Y in New Orleans about a year ago. One was a typical ice pick scar, which responded pretty well to the procedure. I would say that particular scar has received about 45% improvement. My other two scars were a little trickier--they were two small ice picks, but they were right next to each other, so the shadowing made the area appear like an indented line. After punch floats, the area looked about the same as prior to the procedure, maybe slightly better--less than 10% improvement. Since this area (on my right cheek) is so tricky, I am still looking for a suitable treatment. It is important to keep in mind that initially, due to swelling, the scars will look amazing. The swelling, of course, goes away after a couple of weeks, which directly affects the appearance. So, please keep that in mind for people who are rating their results within the first two weeks of the procedure.
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Jade
April 2, 2007

Pros:

Seems to have worked!!

Cons:

A little downtime because of redness & swelling

I had two deep and wide cystic acne scars and I just had scalpel excision with sutures done 3 days ago. Today I had my top layer stitches out and you almost can't tell I had scars there to begin with. I am so happy!!! There is redness and swelling right now so I am hoping when that goes down they still look as good as they do now. Anything will look better than the holes I had. Right now I'd say the improvement is almost 100%. I do believe a good outcome most definately has to do with the plastic surgeon who does it.
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SARAH
February 8, 2007

Pros:

none

Made my scars worse. I am Very dissapointed!
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Finding a Doctor

The right dermatologist can make a big difference to your patient experience and the success of your acne treatment plan. Here are the steps to find a dermatologist who is a good fit:

  1. Use the search feature on the American Academy of Dermatology website to look for board-certified dermatologists in your area, and filter the search results for doctors with a special interest in treating acne.
  2. Read online patient reviews of any dermatologists you are considering and ask people you know whether they have any experience with these dermatologists.
  3. Do your research and go to your first appointment with questions prepared.
  4. Listen to what your gut feeling tells you once you see a dermatologist in person. If you are not completely comfortable, try a different dermatologist.

Finding a Doctor

Only a select few plastic surgeons specialize in acne scar revision surgery. Be certain to find a provider who specializes in acne scar repair and who is passionate and experienced in this area.

Be sure to:

  • Look at before and after photos, the more the better, especially patients with similar scarring to your own.
  • Be realistic about results. Look for improvement, not a cure.

Questions to ask a potential scar revision specialist:

  • Are you board certified? Be certain that they are board certified.
  • How long have you been performing these procedures? Normally, the more experience the better, however, some younger surgeons may be more on top of the latest procedures.
  • Can I speak to some of your other patients? Ask for references for several patients who had similar scarring and speak to them about the process and their satisfaction with results.

Red flags:

  • Their story changes: As you discuss different treatment options, if they tend to change their mind easily, or agree with whatever you say, consider this a red flag. A confident, experienced surgeon will possess strong, unwavering opinions.
  • Your gut tells you "no": Trust your gut. If you just don't feel that the doctor is the right fit, trust that and move on. On the other hand, if you feel they are the perfect specialist for you, trust that feeling.