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My PS suggested Punch excision. Any suggestions? (photos)

helpme102Sep 23, 2016
Hello! Im looking for second, third or more opionions before going through the procedure. PS suggested to do punch excision on my deep scars on my nose. Is this the right and only path to take for these types of scars?? Please advice! thank you all so much.

Answers (4)

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Dr. Jeff Angobaldo, MD
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Dr. Jeff Angobaldo, MD
Board Certified Plastic Surgeon
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Answered on Sep 25, 2016
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Dr. Jason Emer, MD
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Dr. Jason Emer, MD
Dermatologic Surgeon, Board Certified in Dermatology
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Answered on Sep 23, 2016
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Dr. Philip Young, MD
Dr. Philip Young, MD
Board Certified Otolaryngologist
Answered on Sep 25, 2016
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Dr. Davin Lim, MBBS, FACD - Account Suspended
Dr. Davin Lim, MBBS, FACD - Account Suspended
Specialist Dermatologist
Answered on Sep 23, 2016
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Jason Emer, MD

This appears to be a normal healing process. I suggest using normal saline instead of hydrogen peroxide as this damages the surrounding skin and can actually slow down the wound healing process.  Please consult with an expert if you experience further concerns. Best, Dr. Emer

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Jason Emer, MD

That scar shouldn't have been punched out, anyone who does a significant amount of scar surgery know the scar would be 2-3 times the size after in a straight line.  With that said at this point you need lasers, subcision and fillers to improve it.  I suggest you see a laser and scarring expert. ...

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Anil R. Shah, MD

Punch excision is not currently a favored treatment of mine as it has the potential to make acne scars worse.  Essentially a scar is either removed with a punch or lifted with a punch and sutured to the skin.  

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Jason Emer, MD

2mm punch excisions should not be indented, I suggest posting photos and see a cosmetic dermatologist who specializes in scars.  This can be treated with revision surgery, subcision, and/or lasers -- massage or creams will not help.  Best, Dr. Emer.

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Harold J. Kaplan, MD

Hi IA.  It looks like you still have a fairly significant indentation where the scar was excised.  To smooth out the area, you may consider fractional laser resurfacing.  Take a look at an Orange County, California scar removal patient (link below) that came to us after...

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Jeff Rapaport, MD

In my opinion, punch excision should be reserved for ice pick scars. In particular ice pick scars that are less than 2 to 2.5 millimeters. The scars that you are displaying in the photos are saucer-shaped scars. They respond best to subcision and fillers. We have had some success combining...

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