Is serial punch excision a good option for long, depressed Scar?

Question

I have a scar I got when I was young. The scar is very old and depressed. It's about 2mm wide, 19mm long. I know the textbook approach would be surgical excision, but would it be possible to perform a series of punch excisions to reduce the overall length of the scar? I would like to use a 3 or 4mm punch spaced 2 months apart. Attached are two pictures showing what I have and what I'm thinking to have done. Would this kind of treatment be possible?

Jeff Rapaport, MD · Answer

In my opinion,  The downside risk from multiple punch exissions, Leading to additional scarring,  is not worth undertaking.  This scar could be improved with Subcision to lift the base and fractionated CO 2 to smooth the edges.
 We would combine this with a suction device and a micro needle roller. The chance of an adverse effect is minimal.  If additional lifting is necessary, micro needle radio frequency and a filler can be added. Multiple sessions will be necessary. 
Find a scar expert.
Jeff Rapaport MD FAAD 
Realself Hall of Fame

Nelson Lee Novick, MD · Answer

Multiple punch excisions, much like revision surgery runs the risk for the subsequent development of unsightly stretch scars and even tram track-like stitch mark, especially in areas subject to movement. Subcision, which has been used to elevate and smooth all kinds of indented scars, be they from acne, trauma, infection (like chickenpox) or prior surgery, is a relatively inexpensive, quick and simple technique that has stood the test of nearly three decades for both efficacy and safety in all skin types. I personally have been performing with gratifying results it since 1995. Professionally performed manual microneedling (no gizmo RF needed) has also stood the test of over two decades of use for safety and efficacy as a  "polishing" step, if necessary to better blend the surface color and texture of the treated scars with the surrounding normal skin. You would be wise to consult a board certified cosmetic dertmatologist. Best of luck.

Daniel Barrett, MD · Answer

Dear Chris007jr,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from subcision and dermal fillers. If you are considering treatment, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Have a consultation with a facial plastic to discuss your best options.  See an expert!

Best of luck!

Is serial punch excision a good option for long, depressed Scar?

Answers (4)

Answer: Plastic Surgeon

Answer: Plastic Surgeon

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Is serial punch excision a good option for long, depressed Scar?

Answers (4)

Answer: Plastic Surgeon

Answer: Plastic Surgeon

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Recommended reading

Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.