Subcision
Subcision is a non-surgical acne scar treatment that helps smooth the skin with minimal downtime. It’s suitable for those with deep acne scars caused by fibrotic tissue who are seeking a safe, targeted solution for smoother skin.
Table of content : Subcision
What Is Subcision and How Does It Work?
Subcision, or subcutaneous fibrosis release, is a dermatological procedure used to treat depressed acne scars caused by fibrotic tethering beneath the skin. During the procedure, the doctor uses a specialized needle, such as a Nokor needle or cannula, to carefully insert beneath the scar and cut or release the fibrotic bands (fibrosis) that pull the upper layer of the skin downward. Once these bands are released, the skin relaxes and appears smoother.
Additionally, the controlled movement of the needle under the skin triggers a mild inflammatory response, stimulating new collagen production to repair tissue damage. This natural healing process gradually lifts the scar base, making the acne scars look shallower and the overall skin texture smoother over time.
Which Types of Acne Scars Are Suitable for Subcision?
Subcision is suitable for acne scars caused by fibrotic bands that pull the skin downward, creating visible depressions. It is particularly effective for the following types of acne scars:
Boxcar Scars
Boxcar scars appear as well-defined, box-like depressions with sharp edges and a wide base. They are considered moderate to deep scars and often have fibrotic attachments in the dermis. Subcision is an appropriate treatment option, as it helps release the tethered bands beneath the skin, allowing the surface to lift and respond better to other rejuvenation treatments.
Rolling Scars
Rolling scars are mild, shallow depressions with soft edges and an uneven, wave-like appearance. They are the least severe type of acne scar and typically result from fibrous strands under the skin pulling it downward. By performing Subcision, these fibrotic bands can be precisely released, helping the skin relax and appear smoother overall.
Which Types of Acne Scars Are Not Suitable for Subcision?
Ice Pick scars are the most severe type of acne scars. They appear narrow, deep, and sharply defined, often extending into the dermis or even the subcutaneous layer. Because these scars have a very small base and vertical structure, it is difficult for a Subcision needle to access and effectively release any fibrotic tissue beneath them.
Unlike Rolling or Boxcar scars, Ice Pick scars are typically caused by damage to hair follicles and lack significant horizontal fibrotic bands. Performing Subcision on this scar type may therefore increase the risk of bruising, swelling, or tissue trauma without providing visible lifting or improvement.
Who Is Suitable for Subcision?
- Individuals with Rolling or Boxcar acne scars.
- Those without active infection or inflammation in the treatment area.
- People who did not respond well to other acne scar treatments.
- Those seeking visible improvement without surgery.
Pros and Cons of Subcision Treatment
Subcision offers several benefits for improving acne scars, but there are also precautions to consider before undergoing the procedure. Here’s a summary:
Advantages of Subcision
- Targets the root cause of deep acne scars: Subcision releases fibrotic bands that pull the skin downward, allowing the surface to become smoother.
- Highly effective for Rolling and deep Boxcar scars: Patients with fibrotic tethering usually see significant improvement.
- Minimally invasive, non-surgical procedure: Tiny entry points and minimal downtime — most people can resume normal activities right after treatment.
- Can be combined with other treatments: Works well alongside filler, laser resurfacing, PRP, or TCA CROSS for enhanced results.
- Stimulates collagen production: Encourages new collagen formation for stronger, smoother skin over time.
Disadvantages of Subcision
- Temporary bruising or swelling may occur; the risk of infection increases if post-care instructions are not followed properly.
- Must be performed by an experienced doctor, as incorrect technique may cause uneven texture or subdermal lumps.
Subcision Procedure Steps
Subcision is a relatively simple, quick procedure that typically takes about 30–60 minutes, depending on the number and size of acne scars. The process includes:
- Consultation: The doctor evaluates the skin condition and identifies the treatment areas.
- Cleansing and numbing: The skin is disinfected, and a topical anesthetic is applied to minimize discomfort.
- Fibrosis release: A special needle is inserted beneath the skin to cut the fibrotic strands tethering the scar.
- Cooling or laser application (if necessary): Helps reduce swelling and promote faster recovery.
- Aftercare guidance: The doctor provides instructions to prevent inflammation and support proper healing.
Is Subcision Dangerous?
Generally, Subcision is a safe procedure when performed by an experienced doctor in a certified medical clinic. After treatment, mild swelling, bruising, or tenderness in the treated area may occur, but these symptoms usually subside within a few days without any serious complications.
Precautions Before and After Subcision
Proper care and precautions are crucial for optimal results. Neglecting post-treatment care may increase the risk of infection or new fibrosis formation, which could cause uneven skin texture. To minimize these risks and ensure the best outcome, patients should choose a trusted medical clinic and follow the doctor’s instructions carefully throughout the treatment process.
Aftercare Instructions for Subcision
After Subcision, the skin enters a healing phase. Proper aftercare helps reduce side effects and promote faster recovery. Here are the doctor’s recommendations:
- Avoid washing your face with hot water for the first 24 hours. Use clean, room-temperature water and avoid rubbing or using irritating skincare products.
- Avoid makeup for 1–3 days to prevent pore blockage and infection; allow the skin to rest and recover.
- Avoid direct sunlight. Apply gentle sunscreen and wear a hat or carry an umbrella when going outdoors.
- Avoid strenuous exercise or heavy sweating activities such as running or gym workouts for at least 2–3 days to prevent irritation.
- If swelling or bruising occurs, apply a cold compress during the first 24–48 hours or as advised by your doctor.
- Avoid touching or pressing the treated area. Do not squeeze, rub, or pick at the skin to prevent scarring or inflammation.
- Strictly follow your doctor’s instructions regarding medication, topical care, and follow-up appointments.
How Long Does It Take to See Results from Subcision?
Results from Subcision are not immediate. Noticeable improvement typically begins within 7–14 days as the fibrotic bands are released and the skin starts to repair itself. Full results usually appear within 4–8 weeks, once collagen remodeling takes place and the skin texture becomes smoother.
How Many Subcision Sessions Are Needed for Best Results?
The number of Subcision sessions required varies for each person, depending on the type and depth of acne scars and individual skin condition.
- For mild or shallow scars, 1–3 sessions may be sufficient.
- For deep scars or dense fibrosis, 3–5 sessions or more may be needed to achieve optimal results.
Note: If you’ve recently undergone Subcision and haven’t seen visible improvement yet, don’t worry — skin recovery takes time. It’s best to wait 2–4 weeks before assessing early results. For repeat sessions, allow 4–6 weeks between treatments to give your skin enough time to produce new collagen and fully repair itself.
Which Treatments Can Be Combined with Subcision?
After releasing the fibrotic bands with Subcision, doctors often recommend combination treatments to minimize swelling and stimulate continuous collagen regeneration. The choice of treatment depends on the patient’s skin condition and scar type.
Here are effective procedures that can be safely performed alongside Subcision:
- Acne Scar Filler: Helps lift depressed areas by filling the space beneath scars for immediate smoothness after fibrosis release.
- PRP (Platelet-Rich Plasma): Reduces bruising and swelling while promoting cell repair and collagen production.
- Skin Booster: Improves skin hydration, elasticity, and recovery. Popular brands include Rejuran, Exosome, Belotero Revive, Restylane Vital Light, Skinvive, Flore, and Teoxane Filler.
- Collagen Biostimulator: Stimulates long-term collagen regeneration and enhances Subcision results. Recommended options include Sculptra, Gouri, Radiesse, Ultracol 200, Juvelook, Neauvia, HArmonyCa, and Profhilo.
- Acne Scar Lasers (such as Sylfirm X, Fotona Laser, or Fractional Laser): Boost collagen remodeling and improve overall skin texture.
- Pico Laser: Reduces post-subcision redness and pigmentation while brightening the skin.
- TCA CROSS: Ideal for deep, localized scars such as Ice Pick or Boxcar, and can be used with Subcision in areas where fibrosis is present.
For those struggling with acne scars, achieving optimal results often requires a personalized treatment plan. At V Square Clinic, our team of experienced doctors performs detailed skin assessments to determine the most suitable approach for each individual. With precise techniques and high medical standards, we ensure both visible improvement and long-term safety for every patient.
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Summary – Why Subcision Is a Good Option for Acne Scars
Subcision helps release fibrotic bands beneath the skin, allowing smoother recovery without surgery or long downtime. It’s ideal for treating acne scars and can be combined with filler, laser, or skin booster treatments to enhance collagen stimulation and overall skin rejuvenation.
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