How long does punch incision procedure take and the cost? I have many boxcar and icepick scars on my whole face. (photos)

Boxcar scars are from needling for many years that are about 1-3mm and my ice oick scars are mostly 1 mm but wide and 1 mm deep. I will be in fort lee for another week. If its still possible to get the procedure done asap

Doctor Answers 5

Asian skin is very sensitive and needs to be handled with care

Asian skin is generally very reactive and sensitive. Be aware that no matter what treatment you get, the possibility of dark patches of skin called post inflammatory hyperpigmentation (PIH) is real. It looks like you have the dark patches already. There are treatments that are VERY effective - have the ability to banish you scars, but can leave you with PIH that you may deal with for months. I am fair light skin Asian and have had treatments that left me with PIH for 8 months. However, PIH can be bleached out slowly and after 8 months, my PIH is gone.  In your case, PIH may not be acceptable. Some patients question if the risk of PIH is greater than their agony of living with their scars.  Punch excision is not effective when it is in an area of dynamic muscle movement like the cheeks. After punching out the scars with a circular puncher, the skin is sutured and hopefully it stays. Many times, the wounds separate as you smile and talk...then you end up with  deeper bigger scars and PIH. When you see a cosmetic doctor, make sure you get to see their work on Asian skin or any other ethnic, lots of before and after photos and all - that way you'll be more confident going in. Good luck.

Fresno Physician
5.0 out of 5 stars 1 review

Acne Scarring -- Requires a Combination of Fractional Laser Resurfacing, Fillers Like Bellafill, Subcision and Eclipse Micropen

I suggest seeing an expert. I suggest excision with lasers for improvement.  Please see an expert for the best combination options.  Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

TCA CROSS Technique Works Well For Ice Pick (Pit) Scars

From the photos, it would appear that you might better be served, especially since your travel plas seem pressing, by treating the pit scars with the TCA CROSS Technique, using either full strength TCA. Many of them can be treated literally in a matter of minutes. The few remaining depressed rolling scars might profit from subcision with the addition of a filler, for both its immediate lifting ability and its biostimulatory capacity to promote new, native collagen synthesis. Make sure to consult with a board certified aesthetic physician with experience and expertise in all forms of scar treatments. 

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 22 reviews

Acne scars

I would consider TCA CROSS treatment for your scars.  I would recommend that you start by seeing an expert in acne scars to be evaluated in person.  Then an individualized treatment plan can be made. Best of luck.Regards,Dr. Ort

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Facial scars.. Englewood Cliffs NJ

In my opinion, punch excisions may not be the best choice of treatment for your types of acne scars. Your scars are fairly wide and punch excisions are best for deep acne pits. I would recommend subcision plus radio frequency micro needling or non-ablative Laser. Find an acne scar expert. Your skin will need to be pre-treated with a bleaching cream to prevent post inflammatory hyperpigmentation. Hope this helps. Good luck.

Jeffrey Rapaport, MD
Englewood Dermatologic Surgeon
4.6 out of 5 stars 38 reviews

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