Subcision for Acne Scars

Subcision, also know as subcutaneous incisionless surgery, is a minor surgical procedure for treating rolling scars. A needle is inserted parallel to the skin surface in order to detach the rolling scar from the deeper skin. The principle of this procedure is to break the fibrotic strands, which tether the scar to the underlying subcutaneous tissue. The depression is lifted by the releasing action of the procedure, as well as from connective tissue that forms during the course of normal wound healing

 

How is the procedure? Subcision is performed under local anaesthesia. A 20 gauge needle or a Nokor needle 18 gauge, is inserted adjacent to the scar with the bevel upwards parallel to the skin surface, and moved back and forth in a fan-like motion under the scar to release fibrous bands at dermal or deep dermal subcutaneous plane. A small bruise is allowed to be formed, which supports the released scar, because the blood under the skin helps prevent to fibrous strands from forming again.

 

What can I expect? Subcision may be performed alone or as an adjunct to other procedures like fillers, chemical peels, fractional laser, etc. Subcision is a safe, simple technique that provides significant long-term improvement in the “rolling scars” of selected patients. It can be safely and easily combined with other treatments for acne scars. It usually requires at least 2-4 sessions, rolling acne scars response particularly well to this technique, with progressive improvement over time, which can be seen as less shadowing.

 

What is the recovery time? There will be intense swelling for 2-3days and bruising for 7-10 days. Ice should be applied the first day, Tylenol could be used for pain management the first day only if severe pain. The more bruising and swelling, the more beneficial results.

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– Peter Paul Rullan, M.D.