Which Surgery Would Remove This Hole from my Cheek?

Question

I've had the hole on my cheek since then (for about 4 years). It is 2mm in diameter and approximately 2-3mm in depth from the skin surface.   Which surgery would remove (or minimize as much as possible) the hole? What are my options?

Mark J. Lucarelli, MD · Answer

The photo is rather blurry,  but, as several others have commented,  an option that is often useful is excision of the defect and careful layered closure.  During the healing period care must be taken with proper wound care.  If scarring started to re-develop,  steroid injections and other scar treatments could be considered.

	Mark Lucarelli, MD, FACS

	Madison, WI

William Ting, MD · Answer

Punch excision is the standard of care for ice pick scar. The only complication may be if an epidermal inclusion cyst exists underneath the hole where the cyst sac should be removed prior to repair or else you may be dealing with a bigger problem of an inflamed cyst. Consult with a board-certified dermatologic surgeon or plastic surgeon.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

I would recommend using a punch biopsy technique to remove this area.  The skin is closed in a straight line with a few skin sutures.  This is an office procedure.

	Dr. ES

Scott C. Sattler, MD, FACS · Answer

This appears to be an 'ice pick' scar of the face- the simple solution is the remove the scar entirely using a punch biopsy instrument and closing the resulting wound (not much larger than original hole) with a couple of sutures. This will result in a linear scar which should heal quite well. Seek out a board certified plastic surgeon in your area for a consultation.

Matheson A. Harris, MD · Answer

When scars are indented like this, it is best to excise them along natural skin tension lines with careful closure.  The resulting scar will usually be much less noticeable.

Barry L. Eppley, MD, DMD · Answer

The photo makes it impossible to know exactly what this cheek hole is. But the description by measurement suggests it is a small skin indentation that goes just below the skin surface. This could be closed through an excision done in parallel to a relaxed skin tension line or adjoining wrinkle. Because it is a small size, it can simply be closed in multiple layers. This could be done as an office procedure under local anesthesia.

Carlo Rob Bernardino, MD · Answer

It is difficult to completely assess the scar based on the blurry photos. However, this 'hole' is best managed by complete excision and meticulous closure. Although a dermal punch technique is often used, I thing an eliptical excision minding natural wrinkles and contours of the face would give the best result.

John P. Di Saia, MD · Answer

Hello,

	This might be an acne ice pick scar. A scar revision might work but I'd need to see you to figure it out.

	 

	Best Regards,

	John Di Saia MD

Stephen Weber MD, FACS · Answer

I do agree with the previous surgeons that the best option is likely excision of the scar and defect in the skin with very meticulous repair. Additional photos would allow me to give a more specific answer and an in office consultation with an experience plastic surgeon would give you the most accurate information. I would add that a procedure like that I've described can be optimized in certain patients with dermabrasion ("sanding") of the skin about 6 weeks after scar revision.Stephen Weber MD, FACS

D.J. Verret, MD · Answer

There are several options for treatment of scarring. The exact option would be determined after consultation with a surgeon. This looks rather large and more information would be needed before a recommendation would be made. I would suggest visiting a facial plastic surgeon to determine your best option for treatment.

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