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Alternate Saturdays 9am - 5pm.
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Skin Treatment

Minor Surgery


At Amaris B. Clinic, we take a holistic approach to address a wide range of concerns, including nail avulsion and scar revision.


Nail avulsion refers to the loss of a toenail or fingernail due to injuries or trauma. It can be a complete or partial removal of the nail.

Nail Avulsion Can Occur On Fingernails And Toenails

Nail avulsion can occur due to various factors such as accidents, injuries, or ingrown toenails, potentially leading to discomfort and distress.  

Ingrown toenails can result in severe pain, redness, and swelling. They often occur due to factors like genetics, improper toenail trimming, poor hygiene, or ill-fitting footwear.

Nail Avulsion: Symptoms & Signs Of Infection

Watch out for symptoms such as swelling, discolouration, and bloody crusting around the wound lasting for two to three days. Proper wound care is essential for quick healing and infection prevention.

Signs of infection include pus drainage, red streaks, increased swelling, warmth, pain, swollen lymph nodes, and fever.

What Is Surgical Nail Avulsion?

Surgical nail avulsion is a procedure to manage this condition, involving either complete removal or repositioning of the nail. It may also include repair of the nail bed.  

A partial nail avulsion may be suitable for those with ingrown toenails or fungal infections. Full nail avulsion is recommended in cases of deformed toenails, severe ingrown toenails, or significant trauma to the nail area.  

If you have concerns about nail avulsion, consult Dr Ivan Puah for an accurate assessment and appropriate treatment.


Scars are the body's natural response to various skin traumas, from accidents to cuts. When a wound closes, new skin replaces the affected area, resulting in a scar. However, the appearance of scars is influenced by multiple factors, including the original injury's severity, treatment, scar type, location, and genetics.

Composed of fibrous tissues, scars formed due to many reasons. They could result from injuries, infections, surgery or tissue inflammation and can appear anywhere on the body. Scars vary in appearance - some are flat, sunken, bumpy or coloured. They may also be itchy and/or painful.

What Are The Different Types Of Scars?

Scars come in different types, including keloids, hypertrophic scars, contractures and adhesions. Sometimes, abnormal scars are formed after the healing of a wound.

Are Scars Considered Deformities?

Certain scars can lead to physical deformities, as seen in contracture scars that pull skin edges together, causing tightness. This affects joints, muscles, and tendons, often reducing mobility.


Scroll to view the table
Gold arrow
AppearanceTypically stays within the wound areaExtends beyond the wound area and can grow very large
ColourPink to redRed to purple
LocationCommonly occurs in areas where the skin is tautOccurs in both areas where the skin is taut or less taut
Collagen arrangement (microscopically)Fibres are parallel to the epidermis (upper skin layer)Fibres are random and disorganised, with more blood vessels present
Time to developOne to two months after injuryIt can take months or years to develop after an injury
Treatment needsGenerally becomes less noticeable over timeDoes not go away without treatment


A Contracture Scar

Contracture scar is formed when a large skin area is damaged or lost. This type of scar pulls the skin's edges together, causing tightness. This, in turn, affects the joints, muscles and tendons, typically causing a decrease in movement.

An Adhesion Scar

An adhesion scar forms between unconnected internal organs and can cause complications during certain surgeries.

How Long Does It Take For Scars To Improve?

Scars tend to improve in appearance over time. The duration of this improvement varies, ranging from one to two years for some scars and up to three to five years for thicker hypertrophic scars. However, keloids may persist without treatment and may even increase in size.

Are Scars Treatable?

There are different treatments to minimise scars. The choice depends on several factors such as the patient's age, skin type, scar type and severity and location of the scar. It's important to note that while treatments can improve a scar's appearance, complete elimination is usually not achievable.


Depending on the extent of the scarring and disfigurement, there are non-invasive, injectables and minimally invasive solutions to improve the condition. The list of scar-minimising procedures, include:

Chemical Peels

Sun-damaged skin, irregular pigmentation (colour) and superficial scars can be treated with chemical peels. The skin's top layer is removed with a chemical application, which improves its appearance as the skin regenerates.

Collagen And/Or Cortisone Injections

Injectable collagen is often used to treat scars, wrinkles and facial lines. It replaces the loss of the body's natural collagen. Cortisone injections are generally used to soften and shrink hard scars.


As the name suggests, it involves freezing and in this instance, that of the skin's top layer. This causes the area to blister.


It involves removing the top layers of skin. As the skin heals, its surface appears smoother. Dermabrasion is often used to address small scars, minor skin surface inconsistencies, and surgical and acne scars.

Punch Grafts

Punch grafts can be used to treat deep acne scars. During the procedure, the hole is punched in the skin to remove the scar, and it is then replaced with skin, commonly from the back of the earlobe. It is considered a small skin grafting procedure.

Surgical Scar Revision

This procedure aims to create a less noticeable scar. The original scar is surgically removed, and the skin is rejoined. The procedure is done on scars that are wide and long or those that heal in an unusual way. It is also used on scars that appear in highly visible places.

Laser Resurfacing

Aside from wrinkles, laser resurfacing may also be used to treat hypertrophic scars. The procedure uses high-energy light to burn away damaged skin.

How Long Does Scar Revision Surgery Take?

Scar revision surgery takes about one to two hours in most cases. Depending on their size and location, some types of scars may take longer as they require extensive revision and tissue repositioning.

Can A Scar Be Removed Completely?

Scars cannot be removed completely. The available procedures are to help in lessening its appearance. Discussing with a doctor will help alleviate concerns and form a realistic expectation.

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Does the nail grow back after nail avulsion?

Fingernails that have been removed completely usually take about SIX months to grow back, while toenails may take between 12 to 18 months. The affected nails may look different when they grow back as a result of the injury suffered. Nails have been observed to grow back.

When should you get a scar revision?

Over time scars shrink and become less noticeable, so ideally, an individual can wait until it lightens in colour before opting for the procedure. This can take anywhere between months to a year after the wound has healed. Some scars may require a scar revision surgery after 60 to 90 days they have healed. It is best to seek a doctor's advice in regards.

What should a scar look like after 6 months?

The scar will be slightly elevated than the surrounding skin. Its colour and volume will also decrease during the healing process, typically lasting between three and six months. After which, the scar will gradually become paler and softer.

Recovery from scar revision surgery

Do follow all advice the doctor gives and remember to avoid sun exposure for at least 12 months. Many factors contribute to the healing rate, and the doctor will advise a patient regarding this.


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Pico Fractional Laser

Dr Ivan Puah's novel 360° Glandular Tissue Dissection (360°GTD®) technique minimises surgical invasiveness while achieving cosmetic results.

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BioRemodelling HA+ Injection

BioRemodelling HA+ Injection

Dr Ivan Puah's novel 360° Glandular Tissue Dissection (360°GTD®) technique minimises surgical invasiveness while achieving cosmetic results.

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Chemical Peel

Dr Ivan Puah's novel 360° Glandular Tissue Dissection (360°GTD®) technique minimises surgical invasiveness while achieving cosmetic results.

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