Acne Scar Excision

What is acne scar excision?

Acne scar excision is a surgery where a visible indented scar is excised and the wound is closed up with fine stitching. When the wound heals after the removal of stitches, the deep 3 dimensional round indented scar is transformed into a flat 2 dimensional slit-like and less visible scar.

The result ranges from average to excellent. If the slit-like scar is noticeable, it can be further improved by resurfacing CO2 laser treatment.

Why do we choose scar excision and not laser?

Scar excision is used primarily for indented, deep and hard scars like ice picked scars and punch out scars.

With full surface resurfacing CO2 laser, patients will have to undergo several sessions of laser treatment in order to improve these scars. Such scars respond less well to resurfacing laser treatment and the down time from laser is significant. Hence, a good alternative is to surgically excise these scars.

What is a typical treatment like?

A consultation is necessary for Dr Wong to plan for your surgery. Dr Wong needs to identify the suitable scars and the number of scars for excision. The surgery needs to be scheduled and takes about 40-60 minutes for 1-3 scars.

It is a minor outpatient procedure where local anesthetic injection will be used. Several sessions of excision are required if there are multiple scars that require attention.

Are there any possible side effects with scar excision?

Gaping of wound after stitch removal

Constant facial expressions and movements do not sit well with good wound healing, especially with tiny wounds. Hence, it is a challenge! To minimize the gaping of wounds, Dr Wong needs to stitch the wound well and plan for optimal stitch removal timing. Special care in wound dressing also goes a long way in helping to have a nice healing.

Poor wound healing

Good postoperative wound care, antibiotic cream use and minimal facial movement will all help to minimize poor wound healing.

Am I a good candidate for scar excision?

Most patients will have a mixture of acne scars. Some of these scars will respond well to scar excision treatment but not others. Very often, a combination of a few treatments e.g. scar excision, TCA cross, fractional CO2 resurfacing laser will deliver the best overall improvement.

However, there are some patients where they only have a few scars and they are all punch out scars. These will do well with acne scar excision. A consultation with Dr Wong is necessary for proper assessment. If we plan to excise many scars, several sessions will be needed.