Acne scars come in a variety of forms, each of which responds best to one or more of a range of treatments which includes lasers, skin rolling, dermal fillers, TCA Cross subcision and surgery. The anatomy of your scars will determine which treatment or combination of treatments will achieve the best result.
What is subcison?
Subcision is a technique for improving some types of rolling acne scars in which the scar is undermined to release its attachment to deeper structures. New connective tissue forms which helps to ‘lift out’ contour abnormalities.
What does subcision involve?
Subcision uses a special needle or blade to break up the fibrous bands that tether rolling scars to underlying tissue.
Subcision is performed under local anesthesia by inserting this specially beveled needle under the skin so that it is parallel to the skin’s surface. Staying in the plane between the upper layer of the skin and the subcutaneous tissue, the needle is gently advanced and retracted in a piston-like motion, cutting the tethering bands and releasing the skin’s surface from the underlying tissue. See diagram.
The deep portions of the scar are released and its surface elevates as the wound below repairs.
This procedure causes bleeding under the skin which is considered to be beneficial, as blood contains collagen and elastin fibers that help to fill the depression and to replace some of the lost collagen. This cushion of blood may also help prevent reattachment of the fibrous bands that are the cause of the depressed scar and may help level the scar with the adjacent skin.
Is subcision painful?
No, subcision is performed using local anaesthesia.
What are the side effects of subcision?
Temporary redness, swelling, bruising and tenderness.
What are the risks of subcision?
Bleeding, infection and the formation of subcutaneous nodules. Subcutaneous nodules may require injection of corticosteroids.
Am I suitable for this treatment?
Patients with active cystic acne, who have been on Roaccutane within the previous twelve months, who are susceptible to forming keloid scars, who are taking drugs such as aspirin, warfarin or Vitamin E that prolong bleeding, may not be suitable for this treatment.
What results can be expected?
Most patients see some result, averaging approximately 50% impovement after repeated treatments. Temporary swelling initially must not be mistaken for an immediate result. Long-term results accrue over a number of weeks, just as other wounds take time to heal.