Subcision treats depressed tethered acne scars by releasing the fibrous bands responsible for pulling down the skin. Unlike other acne scar treatments that treat the skin’s surface directly, a subcision minimises the appearance of acne scars through targeting deeper layers of the skin.
Deep acne scars are caused by fibrous bands formed during the inflammatory process and left behind during the healing phase. These fibrous bands “pull” the surface of the skin downwards, resulting in indentations. A subcision breaks apart the bands causing depressions in the skin, allowing for the formation of healthier tissue and improving the appearance of acne scars.
A subcision is specifically indicated for depressed acne scars, such as:
Careful examination is key to identifying which depressed scars are suitable.
Patients with active skin infections or who are prone to abnormal skin scarring such as hypertrophic and keloidal scars may not be suitable for Subcision. Patients on blood thinners or who have a bleeding disorder might not be suitable for extensive Subcision as well as there might be an increased risk of bleeding. In addition, extra care has to be taken for patients who have been on oral retinoids for the last 12 months as the risk of poor wound healing is higher.
We encourage all patients to communicate their medical history with their doctors to weigh the pros and cons of Subcision.
After thoroughly cleansing the patient’s face, a topical numbing cream is applied to the treatment area to reduce discomfort and pain. A tiny needle is inserted into the depressed area in the plane of the fibrous bands. The doctor will feel for the bands and move the needle in a back and forth “fanning” pattern to cut the fibrous tissues. This releases the scar from the underlying tissue. Patients may hear or feel a snapping sensation during this process. This is the process of elevating previously depressed skin. Following which, the needle is removed circumferentially around the exit to minimise haematoma formation and remove excess blood. Fillers may be injected to separate the two raw surfaces to prevent the fibrous bands from reconnecting.
Once the procedure is complete, topical antibiotic ointment is applied to prevent infection and encourage healing.
Patients will experience mild bruising for 7-10 days after the procedure. This bruising is normal and supports the skin while it heals. Soreness may also occur for about 2-3 days. Generally, patients are good to go after 5-7 days. Applying the intensive recovery cream given by your doctor will hasten the downtime.
There is no pain during the Subcision procedure as a topical numbing gel followed by local anaesthetic is applied.
Depending on the severity of the patient’s condition, most would see optimal results after 2-4 Subcision sessions, spaced about 1 month apart over a course of 6 months. The results of Subcision also depend on whether the treatment is done with other procedures, such as fillers and laser.