The Best Treatment for Deep Acne Scar?

Consider Plastic Surgery for Acne Scars

In terms of treatment for a deep acne scar, the most effective option is surgical scar removal. There are a number of different surgical scar removal procedures that doctors commonly perform with quite impressive results.

Plastic surgery for acne scars is an ideal choice for those with depressed, pitted, and deep scars such as icepick scars, boxcar scars, and rolling scars.

Surgery is usually performed in a dermatologist’s office under local anesthesia (numbs only the area to be treated) or light sedation (you remain awake).

There are 2 main categories of surgical scar removal procedures that dermatologists commonly perform:

Surgical Treatment for Deep Acne Scar

1 ~ Punch Techniques

Punch Excision:

This procedure is generally used on deep scars such as icepick and deep boxcar scars and is performed under local anesthesia.

A surgical instrument that looks like a round cookie cutter is used to remove the entire scar. The size of the tool is matched to the size of the scar to include the walls of the scar. After the scar is removed with the punch tool, the edges of the skin are sutured together.

The newly produced scar eventually fades and may not be noticeable. If it is noticeable, you can use resurfacing techniques to help fade it completely.

Punch Elevation:

This method of surgical scar removal is used on deep boxcar scars that have sharp edges and normal appearing bases.

The same round "cookie-cutter" punch tool is used to remove the scar but the walls of the scar are left intact. Then the dermatologist takes the base tissue that was cut loose and carefully raises it to the surface of the skin. It is then attached it with sutures, steristrips, or skin glue called Dermabond.

As a result, when the skin heals, the old scar will be level with the rest of your skin. This method lessens the risk of color or texture differences as can be seen with graft replacement, explained below.

Punch Grafting:

In this surgical scar removal procedure, the scar is removed with the same punch tool as above. But instead of suturing the skin edges together, skin is removed from elsewhere on the body, usually from behind the ear, and is used to fill the opening.

With this procedure a color and texture difference may be noticeable, but a skin resurfacing technique can be used 4-6 weeks after the grafting to correct this difference.

Pricing: The common price range for these punch removal procedures is about $250-$300 per scar.

What to expect afterwards: After the procedure, be prepared to experience any of the following: bruising, scabbing, possible keloid formation. Generally you need to allow 6-8 weeks for complete healing.

2 ~ Subcision

Subcutaneous Incision:

Also known as Subcision, this surgical scar removal procedure is used to break up the fibrous bands that cause rolling scars.

Subcision is performed under local anesthesia. Your dermatologist inserts a surgical probe or beveled needle underneath the skin to separate the scar tissue from the skin. This raises the skin and flattens the scarred surface.

Subcision is often combined with resurfacing (dermabrasion or laser).

Pricing: Generally about $50-$750; however, the price can vary greatly depending on if the doctor charges per scar or per session. Often 1-3 sessions are required for real results.

What to expect afterwards: Subcision causes bruising which fades after about 1 or 2 weeks. The risks of subcision include bleeding and the formation of subcutaneous nodules. Bleeding can be controlled with proper use of anesthetics and bandaging, and the subcutaneous nodules can be treated with injection of cortisone into the nodule.


Of course before making any plans to use plastic surgery as a treatment for deep acne scar, be sure to discuss all your options with your doctor along with risks involved and realistic expectations.

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