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Excision Acne Scar Treatment
TREATMENTS_Excision

Excision techniques are very effective for ice pick acne scar

As ice pick scars are quite narrow in appearance, punch-out excisions are preferable, which is mildly invasive but an effective treatment technique.

It is typically performed under local anesthesia in an office-based setting. Usually, one to three, human hair-like, very fine sutures are placed for wound closure. The sutures are usually removed five days after treatment. The healing process continues over many weeks until the visible redness is gone, and the final result can be seen.
The scar we strive for is flat and narrow. It does not cast a shadow, and it can be easily covered with facial makeup. Simply, you are trading a bad scar for a better one.

Biopsy punch wedge excision is regarded as the best treatment for Ice Pick acne scars. As the skin possess appreciable elasticity, the excised hole resulting from the punch out excision can be easily closed.

During the procedure, careful detailed photographs are taken and reviewed on a large monitor together with the patient. Together with Dr. Sadove’s advice, the patient decides which scars they would like to be removed. These are then marked with a marking pen. If you are allergic to lidocaine, make sure to inform Dr. Sadove before surgery.

The acne scar areas that are to be treated are then injected with local anesthesia via a tiny needle, which is similar to that used by the dentist. This step is followed by application of antibiotic prep solution onto the treatment-target skin area. For each scar excision, disposable biopsy punches of appropriate diameter are selected and used. The available, standard diameter sizes of disposable biopsy punches are 1, 2, 3 and 5 millimeters. The scar is “punched out” in a circle shape. Dr. Sadove will ask you to smile and make various facial animations in order to determine the best orientation for the scar. These are called Langer’s lines or elective lines of incision. The circle changes its shape into an ellipse and a fine suture is used to close the excision carefully, by employing plastic surgery technique. After treatment, a dot band aid is applied onto the treated area for a day. This may be removed after a day and face washing can be done. A small amount of antibiotic ointment may be applied twice or three times a day. The fine suture can be removed after five days.

Injections should not be used for the treatment of ice pick scars. Little to no improvement of acne scar would be expected. As ice pick acne scars are too deep, peeling and laser techniques can provide little benefit.

To treat Boxcar scar acne scars, injections are not recommended. Typically, injections may offer little to no improvement due to the tightness of the underlying scar.  Similarly, peeling and laser therapy can provide little benefit for deep boxcar acne scars, as these scars are simply too deep.

( CREATE DIAGRAM HERE FOR EXCISION OF BOX SCAR FROM STOCK )
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Ellipse wedge excision is the best treatment of Box acne scars. The skin has a great deal of elasticity, and the hole created as a result of excision procedure can be easily closed without any tension on the skin closure. Fine sutures are used and removed after 5 days.

During the procedure, careful detailed photographs are taken and reviewed on a large monitor together with the patient. Based on your choice and Dr. Sadove’s advice, the patient decides which scars they would like to be removed. These are then marked with a marking pen. Dr. Sadove will ask you to smile and make various facial animations in order to determine the best orientation for the scar. These are called Langer’s lines. Before undergoing the procedure, make sure to inform Dr. Sadove if you are allergic to lidocaine.

The marked areas are later injected with local anesthesia via a tiny needle, which is something like the needle used by the dentist. To curb the very low risk for infection, antibiotic prep solution is applied onto the target skin area. Then the scar is cut out in a “football” shaped ellipse oriented in the proper direction. A fine suture is used to close the hole carefully by employing plastic surgery technique. After the surgery, a dot band aid is to be applied for one day. This may be removed after a day and routine face washing can be done. A small amount of antibiotic ointment may be applied two or three times every day. The fine suture can be removed after five days.

The final result often takes several months to see until redness and wound healing are completed.
These deep tight scars are best not treated with lasers or peels.

It’s time to get the skin you want.

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