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Acne scar treatment is a long journey and requires a multi-modality treatment plan involving lasers, RF microneedling and injectables such as JuveLook.
For deeper atrophic scars with significant tethering, subcision may be required to release the skin from scar tissue and achieve a good cosmetic outcome. In this article, we’ll explore how subcision works, the types of scars it targets, and what you can expect from the procedure.
Subcision, or subcutaneous incisional surgery, is a minor surgical procedure to treat depressed acne scars. A specialised needle is inserted into the skin to break up the fibrous scar tissue that pulls the skin down. As the skin heals, new collagen is formed and the skin appears smoother.
Subcision is most effective for rolling and boxcar-depressed acne scars. These scars are typically tethered to deeper layers of tissue by fibrous bands, creating depressions in the skin. Subcision addresses these underlying causes, releasing the tension and enabling the scar to rise closer to the skin’s surface.
Subcision is unsuitable for hypertrophic scars or keloids, as these are raised scars resulting from excess collagen rather than tethering bands.
Subcision is an effective treatment for addressing acne scars that appear as depressions in the skin. These indentations are often caused by fibrotic bands, which are thick strands of scar tissue that form beneath the surface and pull the skin downward, creating the uneven texture characteristic of rolling and some boxcar scars.
Subcision physically releases these bands and allows the skin to lift naturally. This process triggers the body’s natural healing response, stimulating collagen production to fill the depressed area and smooth the skin over time.
Subcision offers several advantages, making it a popular choice for acne scar treatment:
Step 1:
Your doctor will assess your condition, before explaining the treatment plan and advise you on what to expect during and after the treatment.
Step 2:
The treatment area is injected with a local anaesthetic (eg Lidocaine with adrenaline) to ensure a comfortable procedure and reduce bruising/swelling.
Step 3:
A blunt-tipped, sharp-tipped or RF-tipped cannula is inserted under the skin. These are specialised needles designed to navigate the subcutaneous and dermal layers to disrupt the scar tissue with minimal unnecessary damage to normal healthy tissue.
Once the needle or cannula is in place, your doctor will move it in a fanning or back-and-forth motion. This controlled movement is crucial for cutting through the fibrotic strands, tethering the scar to the deeper layers of skin. Breaking these bands releases the skin from the underlying tension, allowing it to lift and appear smoother over time. A snapping or crunching sound may be heard as the scar tissue is broken by the needle.
Practitioners may choose different types of cannulas based on the patient’s needs, such as sharp-tipped, blunt-tipped or RF (radio frequency) tip cannulas.
Step 4:
After the fibrotic bands are disrupted, the body initiates its natural healing response. This response includes inflammation and repair, where the controlled trauma triggers the production of new collagen, which helps fill the depressed scar area.
Skin remodelling will occur gradually over the next few weeks and months as the newly formed collagen smooths out the skin’s surface, blending the scarred areas with the surrounding skin.
The tools used for the subcision procedure can make a difference in your experience and results.
Advantages:
Disadvantages:
Advantages:
Disadvantages:
The RF-tip cannula combines the mechanical action of subcision with the additional benefits of radiofrequency energy.
Advantages:
Disadvantages:
At Bay Aesthetics Clinic, we don’t recommend using a sharp-tipped cannula due to the higher risk of complications. Our patients typically choose either a blunt-tipped cannula or an RF-tipped cannula for acne scar subcision.
Subcision is a minimally invasive procedure, but like any treatment, it comes with a short recovery period. Most patients find the healing process manageable, with side effects typically resolving within a week. Here’s what you can expect and how you can take care of your skin to ensure the best results:
It’s normal to experience the following after subcision:
Taking a few simple steps can help minimise discomfort and speed up the healing process:
While complications from subcision are rare, reach out to your practitioner if you notice any of the following:
With proper aftercare, you can expect your skin to heal smoothly and start seeing improvements in texture as collagen production continues over the weeks following the procedure.
Results from subcision vary depending on the individual and the severity of the acne scars. Many patients notice initial improvements within 2–4 weeks as the swelling subsides and collagen production begins.
Full results typically take 1-2 months, with multiple sessions often recommended for optimal outcomes.
For moderate and severe acne scars, subcision can be paired with other treatments to amplify results:
These treatments are often spaced out over several months to allow the skin to heal and regenerate effectively.
Subcision acne scar treatment is suitable for individuals with:
A consultation with a qualified practitioner is essential to determine whether a subcision is right for you.
Contraindications for subcision include:
Risks of subcision include:
Subcision is a good option for improving the appearance of acne scars and restoring smoother skin. Proper planning and professional care can significantly enhance skin texture and confidence.
Bay Aesthetics Clinic and Medispa take pride in helping patients regain confidence through smoother, healthier-looking skin. Whether your scars are mild, moderate, or severe, our team is equipped to guide you through all the steps of subcision treatment.
Book an appointment today.
This depends on your skin condition, typically 2-5 treatments are recommended for best results. A common practice is to perform 1-2 initial treatments and monitor the response, before proceeding with further sessions
We recommend arriving for your appointment with a clean face. Wash your face thoroughly to remove any makeup, oils, or dirt. Your skin should be free of any residue.
Subcision and laser treatments serve different purposes. While subcision targets tethering bands in depressed acne scars, lasers focus on improving overall skin texture and pigmentation. The best option often involves combining both treatments.
Subcision is generally well-tolerated with the use of local anaesthesia. Patients may feel mild discomfort during and after the procedure, but this subsides quickly.
Microneedling is effective for superficial scars and overall skin texture, while subcision specifically targets deeper, tethered scars. The treatments can be complementary rather than mutually exclusive.
Avoid activities that can strain the treated area, such as intense exercise, excessive sun exposure, and applying makeup for at least 24 hours.
Yes, subcision can be performed if you have fillers, but it’s essential to inform your practitioner so they can plan the treatment appropriately.