Excision and Punch Replacement Graft for Acne Scars:
- In excision, the doctor cuts into the skin to remove the acne scar and then closes the wound with stitches
- In punch replacement grafting, the doctor uses a round sharp tool matched to the size of the scar to remove it. A skin graft, usually taken from behind the ear, is used to fill the wound.
Excision and Punch Replacement Grafting Benefits
Patients with deep “icepick” acne scarring are good candidates for excision and punch replacement grafting. These treatments can sometimes be combined with laser resurfacing.
Excision and Punch Replacement Grafting Risks
While no specific risks are associated with excision and punch replacement grafting, patients should be aware that the procedure leaves behind scars that are much smaller and lighter than the original.
What to expect after the procedure
- Patients may not see immediate improvement.
- Wounds must be cleansed, and bandages changed daily.
- Some bruising may occur for the first one to two weeks
Preparing for the procedure
- Thoroughly discuss medical history and expectations with the doctor.
- Arrive to the appointment with a makeup-free face.
Punch Graft Acne Scar Treatment
The punch graft technique is a treatment used to improve the appearance of depressed acne scars.
How Does the Punch Graft Technique Work?
First, you’ll meet with the dermatologist or plastic surgeon who will be doing your procedure. Together, you’ll decide which scars will be treated.
On the day of the procedure, a small punch tool that resembles a tiny cookie cutter is used to cut out the scar. Another small plug of skin, usually taken from behind your ear, is carefully placed in this void. The graft is held in place with sutures, steri-strips, or special surgical skin glue.
(For some scars, the graft might not be needed. Instead, when the scar is removed the tiny opening is sutured closed. This procedure without grafting is called punch excision.)
Your physician will numb the entire area with a local anesthetic before the treatment, so you won’t feel a thing during the treatment (although you will need to endure a needle-stick or two). But the recovery is nearly painless.
Punch grafting is an outpatient procedure, so you don’t need a hospital stay. And most people drive themselves home after the treatment is done.
More good news — there’s minimal downtime. Typically, it takes about a week for the new skin plug to heal. You’ll need to keep a dressing on for about five to seven days. The dermatologist performing your procedure will give you all the details.
Types of Acne Scars the Punch Graft Technique Treats
The punch graft technique works only for deep ice pick or boxcar scars, or those acne scars that are very deep and depressed. By removing the scar and placing in a plug of new skin, it raises that depressed area to the same height as the surrounding skin. Your skin will look smoother and more even immediately after your treatment.
A disadvantage of this technique is it only improves the scars being worked on. So, if you have many scars that need addressing, it can be a long, meticulous procedure.
Also, punch grafting can’t be used to treat raised scars (called hypertrophic scars) or uneven skin tone. Your doctor can tell you if punch grafting is a good treatment option for your acne scars.
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Punch Grafting Can Be Combined With Other Acne Scar Treatments
Although punch grafting makes a big difference in the look of your skin, the procedure itself can leave a slight scar. This scar is smaller, though than the original scar. Instead of a depressed or pitted area, you’ll notice a small line.
Another thing to know — the skin graft may have a different color or texture than the surrounding skin, simply because the skin behind your ear is slightly different than the skin on your face. In general, though, the skin looks smoother than it did prior to treatment. Any unevenness can be faded using microdermabrasion or chemical peels after the skin has healed.
Since most people have several different types of acne scars, you’ll probably need a few different acne treatment procedures done to get the results you’re looking for. This is where a dermatologist is a great help!
