Subcision Acne Scar Removal – Price/cost, FAQs

What is Surgical Subcision for Acne Scar?

Subcision is a minor surgical procedure performed to treat depressed acne scars and wrinkles. We prefer this method to treat depressed scars and deep wrinkles which are tethered down to the deeper layers of skin and muscle.

How does Surgical Subcision work?

Subcision is done by inserting a hypodermic needle or microcannula through a puncture in the skin from the surface.

The tip of the needle or microcannula is used to break the thick strands of scar tissue which pulls the surface of the skin down to the deeper skin tissues and muscle. This releases the scar and stimulates new collagen formation under the scar, improving the cosmetic appearance of the acne scar.

Dermal fillers are sometimes concurrently injected as a spacer after the scar has been released by subcision. Subcision is performed in the clinic setting and is usually well tolerated.

How is Surgical Subcision performed?

Subcision treatment
  1. An assistant will clean and prepare your skin for treatment
  2. The doctor will map out the areas to be treated, including indicating the entry point of the needle or microcannula
  3. Local anaesthesia is injected to the entry points
  4. A hypodermic needle is used to create an entry point, from which the needle or microcannula is directed under the area to be treated
  5. The needle or microcannula is advanced through the dermis and moved back and forth in a fan-like motion (a snapping sound is heard as the fibrous bands are snapped)
  6. Dermal fillers such as Juvederm® can be injected as a spacer concurrently
  7. Manual compression is applied to the treated area to prevent the formation of a large bruise (hematoma)
  8. The doctor repeats the process for the other scar areas

FAQ

How many treatments are required?

Individuals are different in terms of their ability to form new collagen under the treated area. Number of sessions needed to improve a depressed scar depends on the severity, number, type of scars and treatment intensity.

Three to six treatments are sufficient for most cases of moderate scarring, with an interval of one month in between the treatments.

Risks

Surgical subcision is generally a very safe procedure with little downtime but rarely, risks include:

  • Bruising (hematoma).
  • Pain and tenderness of the treated site.
  • Hypertrophic or keloid scars (5-10%).
  • Infection (usually manifests as an acne at the entry point).
  • Temporary post-inflammatory hyperpigmentation.
  • Suboptimal response or lack of response to scarring.
  • Injury to nerve and blood vessels, which is extremely rare when done by trained professionals.

Pre-Treatment Instructions

  • Always inform your doctor of all medications, including supplements you may be taking as well as your medical history.
  • Plan ahead, and schedule your treatment at least 1 month prior to a special event to allow for a full recovery.

Expectations & After-Care

  • The entry points used for subcision usually closes and a scab forms within a day.
  • There can be some bruising, swelling and tenderness over the treated areas for a few. days, make up can be used to conceal the areas of bruising.
  • Use a gentle cleanser during the recovery period.
  • Apply antibiotic cream to the entry points as indicated.
  • Take the anti-inflammatory medication as indicated.
  • Always use sunscreen and avoid unnecessary sun exposure to reduce the risk of post-inflammatory hyperpigmentation.

Treatments that can be combined with Subcision

  • TCA CROSS.
  • Dermal fillers.
  • Fractional CO2 laser.

Who is suitable or unsuitable for Subcision Acne Scar Treatment?

Subcision is generally useful for any healthy adult looking to treat rolling acne scars. These scars appear as depressed scars with gentle sloping edges.

This treatment may be unsuitable in the following circumstances:

  • Unrealistic expectations such as reverting to a former look or complete removal or scarring.
  • History of forming hypertrophic scars or keloids.
  • Current or recent (within 12 months) of systemic oral retinoid medication.
  • Bleeding or blood clotting disorders (coagulopathy).
  • An active bacterial or viral infection.
  • Active acne close to the site of treatment.