Subcision

What is Subcision?

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.

How does Subcision work?

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.

What are some of the areas that Subcision can treat?

A subcision is specifically indicated for depressed acne scars, such as:

  • Rolling acne scars
  • Icepick acne scars
  • Boxcar scars
  • Chickenpox scars

Careful examination is key to identifying which depressed scars are suitable.

Am I a suitable candidate for Subcision treatment?

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.

What is the process of getting Subcision treatment like?

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.

Are there any side effects of Subcision treatment? What is the downtime like?

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.

What results can I expect from a Subcision treatment?

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.

Frequently Asked Questions

let us clear your doubts!

Yes, Subcision in fact complements other treatments and is usually combined with TCA Cross, Rejuran Scar, CO2 Fractional Laser, Pico Laser, Microneedling and Topical Retinoids.

Dermal fillers can help improve rolling acne scars, atrophic scars and tethered scars. The hyaluronic acid in dermal fillers keeps skin hydrated through its water-retaining properties. Fillers also separate the two layers tethered together by the scar fibres that were cut by Subcision, preventing them from healing together again. Combining subcision and fillers can lead to longer-lasting results.

Depending on your skin type, subcision is usually performed with 2-4 sessions for best results. About 60-70% of improvement is seen.

You will not feel any pain during the subcision procedure as a topical numbing gel and local anaesthetic is applied before the procedure. After the procedure, you may experience mild pain and swelling which will subside after a few days.

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