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Surgical Treatment

Published on November 18, 2020. Last Updated on March 18, 2022.

Like any doctor, Dr. Bumpinator performs surgical excisions actually to remove the AKN bump lesions. But that’s not all. He also considers the type of wound closure and the scar left in the wake of the surgery. Intending to create the most optimal esthetic result with the least amount of invasiveness, Dr. Bumpinator developed his own innovative surgical methods to improve the quality of results for his patients.

Using his unique excisions and wound closure techniques, Dr.Bumpinator  addresses two particular areas of concern to ensure the patient’s happiness and overall satisfaction much further down in time:

  1. The possibility of recurrence and making sure that the bumps do not come back
  2. The use of specialized techniques so that the resulting scar looks as natural as possible so that patients do not have to feel self-conscious about their appearance

Recurrence of AKN bumps is possible if the lesional tissue has not properly excised using set principles and protocols. Using his innovative techniques, Dr. Bumpinator makes sure these issues have properly been cared for for each patient.

Any time a surgical excision is performed, it will inevitably leave some scarring. Dr. Bumpinator’s methods produce more discreet-looking outcomes as a horizontal straight line, either covered with hair growth or one that is aligned with the posterior hairline.

Bumpinator AKN Type 2 Animated Episode


Using a number of his innovative techniques, Dr. Bumpinator surgically removed this patient’s Large AKN bump resulting in a straight, horizontal scar that blends a redefines a natural-looking posterior hairline *

Let us remember that patients with Acne Keloidalis Nuchae have endured months or years of experiencing distress or discomfort over worrying about others noticing the back of their head. Creating the final scar to have the best appearance possible alleviates their condition’s emotional and psychological stress.

Dr. Bumpinator Surgical Innovations In AKN

Dr. U (Bumpinator) has himself developed several innovative surgical technique and tools that have made it possible to meet patient’s desire for permanent surgical cure with optimal cosmetic sequelae, including the following:

  • Bat excision for Large AKN lesions: As published in the Plastic and Reconstructive Surgery Global Open Journal, Here Bumpinator developed an excision method that aims to produce a thinner and blended scar with the posterior hairline. It provides for a U or M shape camouflaged well with the new posterior natural-looking posterior hairline.[1]
  • Tension Suturing: Here again, Dr. Bumpinator developed a method and criteria of use for the use of tension sutures to guide AKN wound closure to make large AKN lesions more amenable to surgery to cause faster closure and thinner scars [1]
  • Patented Athena Tension Suture Kit: Invented by Dr. Bumpinator to facilitate tension suturing
  • Granulation tissue debridement: To encourage wound closure by contraction for a thinner scar instead of the wider scars caused by closure by second intention wound healing [1]
  • Trichophytic Excision and Closure: Here, Dr. Bumpinator developed and published in the Journal Of the Academy of Dermatology the adoption of trichophytic techniques for causing thinner, less detectable scarring following excision and primary closure of Narrower AKN lesions. [2]

Animated clip of AKN laser patient at Dr. Bumpinator's office


Hair growth covers the thin linear scar following this patient’s AKN surgical removal by Dr.U.

The result of these innovative techniques is that patients presenting for AKN surgery can find comfort in knowing that regardless of their presentation, they can find in Dr. Bumpinator’s surgical arsenal the methods that would produce the most optimal outcome.


Patient Selection Criteria Developed by Dr. Bumpinator

 As you now know, Dr. Bumpinator’s amazing results are largely due to his surgical methods. But another important aspect is the selection criteria that he developed, matching the right patients with the right treatment approach for their needs.

An important piece of information that often gets overlooked is that AKN comes in many different morphological forms, sizes, and distribution spreads.   Furthermore, unwanted tissue growth appears throughout a variety of different regions on the back of the head. Due to all these individual factors, a one-size-fits-all approach will not work well in every single instance.

And yes, multiple or more customized forms of treatment are also possible. However, there still needs to be objective criteria, not a subjective or arbitrary assignment of one approach over another.

By pairing the right patient with the right technique, like a hand in a glove fit, Dr.Bumpinator helps his patients achieve reliable and consistent aesthetic outcomes that help them feel confident about their self-image once again.

If you happen to suffer from AKN (Acne Keloidalis Nuchae), FD (Folliculitis Decalvans), or any other skin condition you may not be sure about, schedule a free consultation with Dr. U AKA The Bumpinator using the button below to help treat your condition now before it gets any worse.

Claim your free consultation now to see how Dr. U AKA Dr. Bumpinator Can Help Your AKN or condition.

Further Reading

What is Acne Keloidalis Nuchae (AKN)?

What is Folliculitis Decalvans (FD)?


  1. JAAD Volume 5, Issue 6, Pages 529–534,  Selection criteria and techniques for improved cosmesis and predictable outcomes in laser hair removal treatment of acne keloidalis nuchae
  2. JAAD  2019 Jan; 5(1): 24–28, Patient selection criteria and innovative techniques for improving outcome and cosmesis in acne keloidalis nuchae lesion excision and primary closure
  3. PRS Global Open, 2019 May; 7(5): e2215, Innovative Surgical Approaches and Selection Criteria of Large Acne Keloidalis Nuchae Lesions