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Punch excision for acne scars

Punch excision is a method for treating acne scarring in which a punch tool (regularly used for biopsy of skin cancer) is utilized to remove scar tissue. This scar revision treatment is a minimally invasive surgical procedure, ideal for deep ice pick scars. During the procedure, the punch tool is used to remove the acne scar Punch excision is a minimally invasive acne scar removal technique that requires the physical removal of problem skin using a small punch tool. Most plastic surgeons and dermatologists recommend pairing punch excision with other types of scar removal treatments, such as chemical peels and lasers Punch excision is a surgical procedure that's usually used for scar revision. It uses a sharp, cookie-cutter-like punch tool to punch around a scar and ultimately remove it. The remaining hole is then closed with a tiny suture Punch Excision is a long-time technique to improve the appearance of scars. Here, we are using it for acne scars specifically. We use the punch excision tool..

Punch Excision for Acne Scars - Dr

Punch excision is a minimally invasive surgical procedure used to remove acne, moles, cysts and other types of facial scars. In this procedure, a small cutting tool is used to pierce the top layer of the skin, in which the target scar, cyst or pore is physically extracted from the skin Using the technique of punch excision the acne scar is surgically removed through the use of a surgical tool that matches the size of the scar (ideally 1.5-3.5 mm). The remaining wound is closed with a stitch. Punch excision is an ideal technique for revising deep ice pick scars and narrow, deep boxcar scars (<3 mm)

The punch excision acne scar removal method uses a small cookie cutter like tool to cut out the individual acne scar. After the scar is removed, the tiny wound that is formed during the process is covered up using steri-strips There are three different types of punch techniques that are effective in the treatment of deep acne scarring: punch excision, punch grafting, and punch elevation. Punch Excision: A punch excision uses a surgical biopsy tool that punches the scar out from the skin. The tool will vary in width depending on the size of the scar There are different kinds of acne scars, each one requiring a unique combination treatment to treat. In this case, the first step to treating my patients' de.. Punch excision is a specialised excision method to treat a specific type of acne scarring called ice pick scars. Acne scarring can present in different forms that we dermatologists classify as a subtype. These include rolling, boxcar, and ice pick subtypes. Ice pick scars are a variant that present with very narrow but deep openings [

Subcision and Excision in Boston Skin texture irregularities such as acne scars, cellulite, traumatic scars and deep facial lines or folds tend to cast unflattering shadows and age the appearance of skin. Subcision is a simple and safe office surgery procedure performed by Dr. Edwin Ishoo for treatment of depressed lines and scars Biopsy punch wedge excision is the best treatment for Ice Pick acne scars. As the skin possess appreciable elasticity, the excised hole which resulted from the punch out excision can be easily closed. Before the procedure, careful detailed photographs are taken and reviewed on a large monitor together with the patient Punch excision is used when the base of the scar has normal looking skin and punch excision when the base of the scar does not have normal looking skin. The Punch Elevation technique is the same as in the video below, except no tissue is excised from the body

Punch techniques for acne scars are commonly used for depressed or pitted severe lesions. The results are permanent removal of scars since they are literally 'punched' out of the skin using any of 3 techniques - punch excision, punch elevation and punch grafting. This type of acne surgery is very effective to remove, separate, raise or. Icepick Scars Icepick scars are small but deep pits in the surface of the skin. They are treated using an instrument to punch out the pit. This site can be closed with a suture (punch excision) or the underlying skin can be elevated (punch elevation) Excision/Punch Excision. Excision, also known as Punch Excision, is a minor surgical procedure used to treat depressed acne scars. Excision is performed using a circular blade attached to a pen-like handle. The blade is rotated down through superficial and deeper tissues of the skin, into the subcutaneous fat

Punch Excision: The Run-Down on This Acne Scar Removal

punch excision - used to treat mild ice pick scars. The scar is surgically removed and the remaining wound is sealed. After the wound heals, it leaves a smoother and more even area of skin punch elevation - used to treat boxcar scars A punch excision is a method that involves cutting out the ice pick scar. After the excision process, your skin is closed up from all sides. Punch excision is one of the most effective treatments. With a punch excision, the acne scar is surgically removed through a punch matching the size of the scar (ideally 1.5-3.5 mm), and the remaining wound is sealed. Punch excision is ideal for deep ice pick scars and narrow, deep boxcar scars (<3 mm), said Dr. Chwalek This ensures that the scar site is overlaid by new skin, which in turn allows the healing process of the skin to initiate. Use of Skin Grafting in Punch Elevation Acne Scar Removal. Most contemporary punch elevation treatments are completed with a skin graft. This is regarded as a progressive option for covering the minimally-punched acne scars

Punch excision is a surgical procedure used for deep acne scars. This method of treatment for acne scars requires local anesthesia. A tool called a punch biopsy tool is used to cut out the scar. The normal edges of the skin are then stitched together. This allows a more controlled healing process Both Restylane® and silicone are injected into acne scars to raise the surface of the skin and give a smoother look. Fillers do not last - they are a temporary solution to acne scar removal. SCAR EXCISION (aka Punch Excision) is a surgical method of treatment that uses a scalpel or punch to remove the scar. Under local anesthesia, the scar. Surgery (punch excision) to remove indented scars by cutting them out of the skin, which may include the use of a skin graft For many patients, a combination of treatments may be most effective in improving the appearance of acne scars Punch excision treatments for acne scars is one of the most common and most popular methods for treating and eliminating scars from acne. Ice pick acne scars are best treated with punch excision treatment, whereas punch excision treatment with derma grafting is more preferred for larger areas of acne scar treatments

Is Punch Excision for Acne Scars Worth the Cost? RealSel

  1. However, in case of severe acne, surgery can be used to correct the problem. One surgical technique is the punch excision method. In the Punch Excision method, deep scars are rectified using the punch biopsy tool. Mostly this form of surgery is used to treat icepick acne scars. The tool size is matched with the scar so that it can be correctly.
  2. ate bigger scars. There aren't any particular dangers linked to punch excision. If you do not want the lighter resultant scar, then a great choice for you is laser skin resurfacing
  3. Generally, very deep acne scars that are less than the diameter of the punch (usually 3mm in diameter) are candidates for punch excision as these scars respond very poorly to other modalities of acne scar treatment such as subcision and fractional lasers. Such very deep acne scars with a small surface diameter are also known as ice-pick.
  4. Subcision is beneficial when acne scarring has left 'depressions' or 'divots' on the skin's surface. The procedure involves breaking up the fibrous tissue under the scar which pulls the skin downwards. Punch Excision, Punch Elevation and Punch Grafting are techniques where damaged skin is removed by excision of tiny areas of scarred.
  5. Punch excision. Punch excision is used to treat deep ice pick scars. Your dermatologist makes an incision in your skin, removes the scar and places a skin graft over the area. The procedure leaves behind its own scar, but that scar will be much less noticeable than the original scar. Laser treatmen
  6. or surgical procedure used to treat every scar separately. It involves incision of scar and stitching it to reduce its appearance. The surgery depends on the type of scar and healing time is dependent on the surgery. Dr. Behnam is a professional when it comes to acne scars and offers acne scar removal Los Angeles
  7. Punch techniques including punch excision, punch elevation, and punch grafting are used to treat ice pick scars and other depressed scars. A small punch tool, which is often described as a tiny, circular cookie cutter, is used to cut the scar from the skin. After the scar is excised, the skin is sutured closed

The treatments he uses for acne scar surgery in St. Petersburg include, but are not limited to: punch excision of deep ice pick scars, deep but graded facial resurfacing with various lasers and chemical peels, including our very own unique Hetter Facial Resurfacing Procedure, subcision for rolling scars to break up the tethering to the subcutaneous tissues, TCA CROSS, microneedling, PRP. Punch or elliptical excision to the subcutaneous level is preferred for ice pick scars 1, 12, 14, 60 and also deep boxcar scars. 2 Punch excision removes a pitted scar with a straight-walled disposable or hair transplant punch that is slightly larger than the scar being addressed. 6, 28 The goal is to trade a larger, deeper scar for a smaller. What you should know about punch grafting for scars. The skin plugs inserted into the treatment area usually are removed from behind the ear lobe. The plugs are taped into place for about a week to promote healing. While the procedure produces new scarring, the new scar will be smoother and less conspicuous than the old depressed scar

TCA CROSS and punch excision for deep ice pick scars and narrow box car scars; Microneedling with PRP to improve the results of laser treatments and to accelerate healing time; What is Punch Excision? An alternative or complement to TCA CROSS is punch excision, in which the troublesome ice pick or pore is surgically removed from the skin. Using. Treatment options for Ice Pick scars include punch excision and this can be an option with a broad price range, as you might pay between $500 and $1000 per individual scar. However, a more cost-effective treatment, Microneedling might be appropriate for this scar type for some individuals and the cost for this is upwards of $500 per treatment. The recovery time for punch excision is more than that of many other methods for scar removal. Even if you feel fine shortly after the procedure, it is advisable to put on a dressing for about a week following the procedure. Fillers can help. At times, acne scars cause a permanent indentation in the skin and this may be difficult to reverse Two surgical procedures can be done to improve the appearance of acne scars. Subcision; Punch excision; Subcision. In this procedure the aim is to elevate the depressed scars by introducing a sharp needle beneath the scar that break the fibrous adhesions tethering down the scar. This leads to lifting of the skin at the base of the scar Both Restylane® and silicone are injected into acne scars to raise the surface of the skin and give a smoother look. Fillers do not last - they are a temporary solution to acne scar removal. SCAR EXCISION (aka Punch Excision) is a surgical method of treatment uses a scalpel or punch to remove the scar. Under local anesthesia, the scar is.

Acne scars Treatments: Acne scar removal is a very vast and complex subject. Punch excision is another variant consisting of suturing the defect after the scar has been punched out and discarded. Ablative Laser Resurfacing can be used instead of or in addition to punch excision. We often use the two together for best results Traditionally, punch excision and grafting have been performed, followed 1-2 months later by dermabrasion. Objective: To determine the effectiveness of laser skin resurfacing and the concurrent use of punch excision performed at the same treatment session in the treatment of acne scarring The acne scar removal program synergizes various treatment methods. These include Subcision , TCA CROSS , punch excision, Dermal Fillers, INFINI skin resurfacing , Lasers for pigmentation and anti-inflammatory injections for keloids may be added to achieve the best results where needed

Punch Excision Acne Scars West Hollywood, CA Dr

Excision and Punch Replacement Graft for Acne Scar

In a punch excision procedure, the doctor cuts out, or excises the acne scar, and then closes the wound in a manner that prevents further scarring. Punch excision is ideal for the most stubborn scars since it entails surgically removing the scarring area Punch excision. Some authors have advocated punch excision with full-thickness graft replacement as a means for improving deep icepick acne scars. 12 The postauricular skin is most often used to create these grafts. Unfortunately, the thickness and color of the postauricular skin often creates a color and textural mismatch leading to unnatural-appearing circles on the face

When we treat multiple areas of deeply depressed acne scars, often a punch excision of these small scars, and I use a tiny little punch biopsy tool, which takes out just the scar itself, and I'll replace the punched out scar with some tissue that I can barrow from behind the ear with a similar matching punch Acne Scar Removal Treatment. Unfortunately, many people in Honolulu think that acne scars will fade as time passes, and, while it may happen, it's not something you should expect. The best method of dealing with acne scars is undergoing cosmetic services for treatment designed for acne scar removal. Laser Skin Resurfacin METHODS A Medline search was performed on the various treatments for acne scars, and particular attention was placed on articles that used the acne scar classification system of icepick, rolling, and boxcar scars. RESULTS Therapies for acne scarring included surgical modalities, such as subcision, and punch excision Papaya Mask for Fading Pitted Acne Scars. Over-the-counter Creams for Fading Acne Marks. MSM Cream for Pitted Acne Scars. Laser Surgery is a Good Alternative. Fractional CO2 Laser to Treat Deep Pitted Acne Scars. Punch Graft Treatment for Deep Acne Marks. Punch Excision Treatment for Deep Pitted Acne Scars

Punch Graft Acne Scar Treatments - Verywell Healt

Sutures are removed 7 days later to prevent track-mark formation. Some authors have advocated punch excision with full-thickness graft replacement as a means for improving deep ice pick acne scars.28 The postauricular skin is most often used to create these grafts, but pigmentation defects may result.29, 30. Punch elevatio Punch technique : With a punch excision, the acne scar is surgically removed through a punch matching the size of the scar and the remaining wound is sealed. Steroids treatments : Steroid treatment This can be in the form of an injection or a corticosteroid cream. If injected into the acne scar it then shrinks or flattens the scar tissue which. Using a minor procedure called punch excision, your doctor cuts out individual acne scars and repairs the wound with stitches or a skin graft. With a technique called subcision, your doctor insert Acne scar surgery involves a minor procedure that makes the scar less noticeable by lifting the scar or breaking up the scar tissue. Punch excision is best for icepick scars that are deep and have jagged edges. The scar is removed and the wound in sutured closed. There will be a tiny scar that can fade on its own or be followed by a chemical. Punch excision of acne scars are reserved for the more stubborn scars. These are usually the more tethered ice-pick and box scars, but can even be used for deep open pores. This needs to be done carefully as there is a risk of leaving a new scar after cutting off the old scar

Acne Scars Treatment in Rajouri Garden, West Delhi-Skinology

Punch Excision - Scar treatments - Acne

  1. Surgical Removal (Excision) of Acne Scars. When treating ice pick type scars, surgical excision is usually required. There are no lasers or technology-based approaches which will provide adequate correction of the scars. Ice pick scars are frequently found on the cheeks and temples. Removal of ice pick type acne scars is performed in the office.
  2. Punch Excision. A useful technique particularly for icepick acne scars. A circular punch is used to core out the scar, thereby freeing the tissue around the scar, which is then sutured. Punch Elevation. This technique is used to elevate depressed acne scars
  3. Again, for those in the back, each scar type must be matched to the appropriate treatment method. For example, a patient presents with acne scars of varying types. The treatment plan may include TCA CROSS for ice pick scars, subcision and dermal fillers for rolling scars, and surgical removal for a few of the deep, non-distensible boxcar scars

Punch excision technique: The punch excision of icepick acne scars or deep boxcar scars is a technique that can be easily adopted into a dermatology practice. Most dermatologists are often performing punch biopsies for diagnostic purposes of inflammatory dermatoses. The same technique is used to remove appropriate acne scars Punch Removal: individual marks such as ice pick and boxcar scars can be surgically removed. Several different techniques can be used to remove mild or severe scars. A small skin graft is sometimes needed to seal the surgical wound. Although the cost of acne scar removal can be high, it can be worth it in order to free yourself from. There are several effective treatments for ice pick scars: TCA Cross. Subcision. Fractional CO2 (high settings) Punch excision. 80-90% improvement for ice pick scars is possible after several treatment sessions. There isn't a single best treatment for ice pick scars. I usually combine several treatments for ice-pick scars as this gives the best.

Laser Acne Treatment Cost | Laser Scar Removal Cost

Downtime for Punch Excision of Acne Scars

Anyway, like other non-invasive scar removal treatments, it also requires multiple visits to the doctor's office. Punch Excision: You can go for punch excision if you desire an instant improvement in your acne scars. This treatment involves utilizing a sharp blade-like tool to cut into the skin and extract scar tissues Punch techniques can be an effective treatment for two out of the three main types of acne scar and can be useful in the treatment of both ice pick scars and boxcar scars. Punch techniques can be split into three categories: - Punch excision - this involves the surgical removal of a scar and the closing of the wound to create an even. Welcome to Acne Scars NYC at Acne Scars NYC at Acne Scars NYC Treatment Center in New York, NY headed by a board certified Dermatologist in New York, NY with international acclaim as one of the Top Laser Experts for Scars in Manhattan and the world. TCA CROSS or punch excision followed by laser nyc new york ny Ice pick scar....sounds deep. Punch surgery is a technique used on those pesky much deeper acne scars: icepick or boxcar. Punch Excision This strategy uses a punch biopsy instrument which is basically a round, sharp cookie-cutter tool that comes in diameters ranging from 1.5 mm to 3.5 mm. The size of the device is matched to the size o

A punch excision uses a punch biopsy which is a round scalpel that is similar to a tiny cookie cutter. The result is usually a small line that replaces the hole of the acne scar. Hopefully the line will fade with time, however acne scarred skin often does not heal as well as normal skin and at times the skin does not stay together when. 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. The result ranges from average to excellent. If the slit-like scar is noticeable, it can be further improved by resurfacing CO2 laser treatment For deep acne scars, minor surgery may be the answer. A punch excision removes the scar tissue and repairs the wound with stitches or a skin graft. This technique is often used to treat deep acne scars We propose a descriptive, simple, universally applicable acne scar classification system that includes 3 scar types: icepick, rolling, and boxcar. We also have developed an effective treatment algorithm for reconstructing and improving the appearance of acne scars including punch excision, punch elevation, subcutaneous incision (Subcision), and.

Acne scars: What's the best treatment? - Mayo Clini

Punch Graft Excision As An Acne Scar Treatment As the name might suggest, acne scar removal in punch graft surgery is achieved through the use of a surgical tool to excise individual acne scars. Skin grafts taken from other parts of the body (e.g. behind the ear) are then used to replace the tissue that was removed Punch Excision or Replacement Graft: Punch excision of each individual scar is a technique for ice pick scars. In this procedure, each scar is excised down to the layer of subcutaneous fat; the resulting hole in the skin may be repaired with the punched skin glued or sutured at skin level, or the resulting hole may simply be closed with a. Punch excision is a minor procedure often used to remove acne scars. A dermatologist will cut out individual scars and then close the wounds with stitches or skin grafts. Sometimes people also get. For ice pics scars, a procedure called punch excision is sometimes used. This technique involves the use of a cookie-cutter-like instrument to remove or punch-out the deep hole in the skin. Once the scar is removed, the remaining skin can be sutured back together

Punch excision. A punch excision involves a doctor cutting out individual scars and repairing the wound with a skin graft or stitches. The procedure leaves a scar that is smaller and lighter than the original. It is most effective for deep ice pick scars. Instant Treatments for Acne Scars. Hypertrophic or atrophic scars cannot be treated instantly We offer most effective laser for Acne scars: iClear™, a combination laser-based system is offered in San Antonio and Boerne Acne Clinics Call 210-698-6777 . Call us 210-698-6777. Punch excision and grafting is used for deep ice pick scars that cannot be effectively treated any other way There are three types of punch excision and they all use a punch biopsy tool to correct deep acne scars. Punch excision removes the base of the scar, and the skin is then closed with sutures and allowed to heal. Punch elevation uses the punch tool to remove the base of the scar which is then sutured to the surrounding skin

Excision and Punch Replacement Graft for Acne Scars

Punch excision can be a wonderful method for diminishing ice-pick acne scars. A punch excision closes a scar with sutures, allowing the dermatologist to bring the dermis back together in a uniform line. This procedure can leave behind a faint, tiny scar, but this can often be eradicated with dermabrasion, laser resurfacing, or chemical peels.. Minor surgery (such as subcision: cutting the fibers that pull the surface of the skin down in depressed scars; or punch excision: cutting out ice-pick type scars) TCA peel solution (Trichloroacetic acid peels are a type of chemical peel that can range in depth, from superficial to deep Punch techniques are minimally invasive surgical procedures that can be highly effective in improving the appearance of acne scarring. There are three types of punch excision and they all use a punch biopsy tool to correct deep acne scars. Punch excision removes the base of the scar, and the skin is then closed with sutures and allowed to heal. Punch techniques are the go-to pimple scar surgery. They are commonly paired with other surface-level treatments to reduce the appearance of large scars. Injections for Acne Scars

Left cheek punch excision stitches removed 4/29/09Acne Scar Treatment Manchester | Acne Scarring | UK

Punch Excision, Punch Elevation for Difficult Scars. Punch excision is sometimes performed on patients who have depressed, ice pick scars. It is a method for removing severe acne scars that are very deep, which other methods will likely prove ineffective. A small pen-like tool is used to puncture the top layer of the skin to precisely extract. The treatments for acne scars depend on the assessment of the type, extent and location of the acne scarring and will include surgical dermabrasion, punch excision, subcision and laser, depending on the individual findings. Ice pick acne scars are small deep holes that can be dermabraded or excised. Dermabrasion involves removing the. Punch Excision of acne scars; TCA CROSS (Chemical Reconstruction of Skin Scars) There is a myriad of treatments that are available for the treatment of acne scarring but unfortunately, most of these are mild low-grade aesthetic/beauty therapy treatments. This section of Dr Hussein's website is designed to give you specialist advice on the. How it works: Excision is like a scar revision. The physician removes a deep scar and stitches the wound. This creates a new and improved scar. Punch grafting removes a deep scar and replaces the lost tissue. The replacement tissue is color and size matched skin from another site. In both procedures, the doctor will inject numbing medicine into.

Treat Acne Scars with Punch Excision and Skin Grafting

Punch Excisions: For the punch excision acne scar treatment, Dr. Jacono uses a small medical biopsy instrument to punch or cut out the acne scar from the skin. Once the acne scar tissue is removed, Dr. Jacono will then stitch the skin back together. The scar that is left from the punch tool will eventually fade with time Studies show that by amping up collagen production, skin becomes more elastic and acne scars are minimized. 4. Punch Excision. Studies report that punch excision is very effective in getting rid of acne scars. This treatment uses a small scalpel to punch holes in the skin, cutting out the existing scar tissue Punch excision, elevation and grafting. Punch techniques are types of minor surgery carried out to remove acne scars. Excision is usually used for ice pick scars. The scar is cut out of the skin using a special tool, and the wound is stitched flat. Elevation is usually used for boxcar scars Special procedures for acne scarring e.g. subcision, punch excision/ punch elevation of boxcar acne scars, TCA ablation of ice-pick acne scars; What to expect? All acne scar patients require a thorough pre-treatment assessment to reach a fully informed treatment plan. The patient has to be off systemic isotretinoin for at least six months prior. Boxcar acne scar treatment. This type of scar is easily treated with traditional acne scar removal treatments such as a subcision or a punch excision. A subcision is a simple outpatient treatment that involves penetrating the skin with a needle to promote collagen production, and results may be visible after 1 or 2 days

Punch Excision - Veritas Clini

Scar treatments are among the core procedures performed at our practice. To benefit the large number of our acne scar patients we operate the most effective lasers for scar removal. Our experience enables us to combine lasers, punch grafts, Photodynamic Therpay, fillers and peel treatments to offer you the most efficacious and cost effective. Be able to perform acne scar levelling treatments ie. subcision, and punch elevation/excision; Be familiar with other acne scar treatments options such as dermal filler injections, TCA Cross, laser and microneedling (with RF or PRP), and be comfortable recommending them in your clinical practic Procedures such as punch excision or TCA CROSS can improve deep ice pick scars. Once scars are raised up to a shallower level, laser resurfacing provides the finishing touches. Rolling, atrophic and depressed acne scars. Rolling acne scars appear as undulations and depressions on the skin. Some scar areas may be anchored to deeper structures Treatments for acne scarring include microneedling, TCA CROSS, subcision, punch excision, fillers, and laser resurfacing or fractional laser treatment. Rolling scars are best treated with subcision whilst boxcars respond well to laser treatments. Ice pick scars can be treated with punch excision, TCA CROSS and/or laser resurfacing

Acne Scar Treatment | Solomon Facial Plastics TorontoWHiTe CoLLaR LaDy: ACNE SCARS5 Most Effective Acne Scar Treatments - What Are They

Punch Excision Treatment London & Surrey, UK Dr H Consul

The common acne scars treatment for the ice pick scars include punch excision or punch grafting. Boxcar type acne scars. The appearance of the Boxcar acne scars is usually round or oval with quite steep vertical sides. The boxer acne scars are wider in size than the ice picks. These acne scars lend a pitted appearance to the affected area. The. Punch excision is a surgical technique that can be used to correct deep acne scars (eg ice pick and boxcar scars). During this procedure, your cosmetic doctor will use a punch biopsy tool (circular blade) to cut out deep acne scars. The remaining skin edges are then sutured together with a single stitch Acne scar removal treatment using punch excision may cost you around Rs 15,000 to Rs 25,000, while dermal fillers may come at a price range between Rs 20,000 and Rs 1,00,000. Skin grafting involves an expenditure between Rs 50,000 and Rs 1,00,000, on the other hand, acne scar removal creams come for a price range between Rs 900 and Rs 2,000 Surgical removal: The doctor cuts the scar from the skin, allowing blood to clot beneath and produce connective tissue to smooth the surface of the skin. Techniques include punch elevation and punch excision for deep scars, and subcutaneous incision for rolling scars. Cryosurgery: Liquid nitrogen is applied to the skin to freeze the scar, which. Punch excision is a technique that involves removing the top few layers of skin covering an ice pick scar. Dermatologists do this using a punch tool that is similar in size to the scar

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