Augmentation, Punch Excision, Punch Elevation for Acne Scars

Augmentation is a unique method among acne scar treatments. Material (mostly collagen) is injected under the scar, which causes the scar to float up to the surface of the skin. Sometimes, one’s own fat is used as the injecting material. This method does not cause any swelling that might require time to recover. Augmentation of soft tissue is expected to become a more permanent acne scar treatment in the future.

Soft tissue augmentation means filling the defect in the dermis through infiltration of certain substances known as fillers. This will correct atrophic scars. Previously collagen or fat from other parts of body was injected beneath the scar to raise the skin to the surface level. Nowadays many artificial types of fillers are available. Collagen injections are temporary, and last about 6 months.

There are many types of injectables used for augmentation. Unfortunately, most of the injectables widely available are not considered permanent. In addition, some are not available in all countries. Here is a list of some of them to get you started in your research:

Different types of fillers used in skin augmentation:

• Isolagen
• Fat
• Fascian
• Restylane
• Collagen
• Artecoll
• Aquamid
• AlloDerm

The disadvantage of soft tissue augmentation is that it has to be repeated every 6-10 months.

Punch excision

Ice pick scars and deep pit scars are best treated with the punch excision method of scar removal. It is the most basic scar removal procedure used for most types of acne scars. Each scar is treated separately to improve the appearance of depressed acne scars.

A punch excision utilizes a punch biopsy tool that looks a bit like a small, round, sharp cookie cutter. It may vary in width depending on the size of the treatment area, generally between 1.5 mm and 3.5mm. Local anaesthesia is applied to the area and the tool is used to remove the scar and its surrounding edges. Now that the scar is removed the skin is sutured together and heals.

You must know that the procedure leaves behind a small and much lighter acne scar in comparison to the original one. In case you are not happy with it and want that scar to go away, you could go for laser resurfacing that would fade away even that minor scar.

Are there any risks involved?

There are no specific risks involved in punch excision acne scar removal method. Only if you think that you don’t want the lighter resultant scar then you can go for another treatment which would solve the problem completely.

A piece of advice

It is advisable to approach a plastic surgeon instead of a dermatologist for the procedure. Also, go for a two layer stitching which would prevent your acne scar from opening up again the future.

Punch replacement technique

This procedure is the same as punch excision. However, instead of suturing the skin surrounding the scar with a tool, the area is filled with a skin graft, usually taken from behind the ear.

This method is thought to be the most successful, for treating deep scars. However, punch surgery may take several weeks to heal.

Punch elevation

One punch technique is “punch elevation” which is used mainly on deeper boxcar scars. The concept is to remove the scar using the same excision technique where a biopsy tool removes the scar, but rather than suture or graft the wound, the scar tissue is then elevated and reattached. This diminishes the depth of the scar and minimizes the likelihood of discoloration from different skin being grafted in its place.

After the treatment is over, the skin appears even. The pitted or pock marked look is greatly reduced. Although this treatment may leave behind a scar, it is much smaller than the original one, and can be further treated using techniques like dermabrasion or chemical peels. This technique is most suitable for deeper scars like the boxcar scars.

On one hand, whatever acne scar treatment you decide upon, keep in mind that some may require more than one session with a doctor. There is a wide variation with the costs associated with the various treatments. Make sure you consider the financial ramifications with your treatment plan before you proceed. Remember, more than one treatment plan may be effective in your particular situation. Each plan has benefits and drawbacks so make sure which procedure is appropriate for you and always consult your dermatologist before making a decision.

On the other hand, natural creams are becoming more and more popular to remove acne scars. Simply because they are natural, easy, and they work. You can simply apply them to the affected area of your skin that has acne scar, and soon after a few weeks you can see obvious results that they are fading away.