• Punch Excision

    in London and Surrey

INTRODUCTION

Using the technique of punch excision the acne scar is surgically removed through the use of a surgical tool that matches the size of the scar (ideally 1.5-3.5 mm). The remaining wound is closed with a stitch. Punch excision is an ideal technique for revising deep ice pick scars and narrow, deep boxcar scars (<3 mm). This can be a much faster and efficient way of resolving these more difficult scar types.

Many of the cosmetic problems faced by acne scar sufferers arise from the indentation and visibility of deeper scars. Punch excision effectively turns an indented scar or hole into a flat linear scar. These flat linear scars can then be further improved with laser resurfacing and the resulting minimisation in scar appearance will be much more cosmetically acceptable. The resulting modified scar would also be flat and easily disguised with a light layer of foundation or make-up.

Please look at the videos and photos below of cases performed with punch excision.

TCA CROSS is a useful acne scar treatment procedure but it can be a costly, time consuming method that mildly improves scar appearance. The advantage of punch excision is that it is a one-off procedure that gets rid of the scar tract completely. Wound healing will take around three months to complete but laser resurfacing can be performed 4 weeks post procedure to further improve scar appearance.

PROCEDURE DETAILS

The relevant scars that are to be treated are agreed upon and marked buy Dr Hussein. Once marked Dr Hussein will confirm the scars using a mirror or photo.

The appropriate punch size will be selected in accordance with the size of scar to be removed. This will usually be the punch size that is closest match to scar diameter. Generally this varies from 1.5mm – 3.5mm.

A circular motion and pressure will be used to drill out the scar and the resulting detatched scar will be removed. The remaining wound will then be closed with a non absorbable stitch that will need to be removed after 7 days.

DR HUSSEIN CASE GALLERY

Punch Excision – Part 1

Punch Excision – Part 2

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POTENTIAL COMPLICATIONS

These include the following:

Scar:

This technique is a scar revision technique. The purpose of which is to minimise the appearance of an existing scar. It will also result in new scar formation but is performed on the basis that the resulting scar will be a cosmetic improvement.

Infection:

Like any surgical procedure punch excision carries a risk of infection. Appropriate wound care instructions should be followed and these will be issued to you after the procedure by Dr Hussein.

Bleeding:

Although unusual it is possible to get a small amount of bleeding from the stitched punch excision wounds.

Wound dehiscence:

Tension or pulling on the wound may cause the stitch to break. Facial stitches are thin and delicate. If this happens the wound may open. This may necessitate further revision surgery and a larger scar. Care must be taken to ensure that the recovering wounds and stitches are not caught, scratched or pulled.

AFTERCARE

Following the procedure of punch excision the following wound care should be observed.

  • Care and attention must be given in order to prevent any tension on the wounds or stitches.
  • Daily face washing must be performed gently with a soap free cleanser and lukewarm water.
  • A topical antibacterial ointment such as chloramphenicol should be applied to individual wounds gently with a cotton bud twice daily for 3 days. Following this, a small amount of Vaseline can be applied in a similar fashion until the stitches are removed.
  • It is essential to attend the appointment for stitch removal at the designated time. Leaving the stitch for longer than necessary will result in suboptimal wound healing.
  • The wound should be treated with great care in the first few weeks following stitch removal with minimal tension applied to the treated areas.

COST

  • Punch Excision – £1500 per treatment session

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