Treatment

Acne Scarring Subcision Treatment

What is Subcision?

Subcision is short for Subcutaneous Incisionless Surgery, meaning there is no incision or cutting of the skin. Instead, a hypodermic needle or blunt cannula enters the skin via a small entry point and is then moved backwards and forwards (and sideways if necessary) in the deep dermal plane.

What is the purpose of Subcision?

Subcision is a technique commonly used to help improve the appearance of certain types of scars. Scars that may respond well include rolling acne scars (with an undulated appearance of the skin) and anchored scars (that deepen or pucker with facial movement such as smiling).
Ice-pick and boxcar scars may also improve, though combining this with other techniques such as TCA CROSS may support more refined results.

How and why does Subcision work?

These types of scars often have fibrotic strands that tether the skin or scar tissue to the underlying layers, such as the fat or SMAS layer. The needle or blunt cannula is used to carefully release these fibrotic strands, allowing the skin to appear smoother as the area lifts.

The minor trauma from the procedure can cause a small amount of bleeding beneath the skin, which is part of the normal healing process. The underlying haematoma helps prevent the fibrotic strands from reattaching, and the blood contains growth factors that may support natural collagen formation as part of the skin’s healing response.

Platelet-rich plasma (PRP) or collagen-stimulating injectables may also be used concurrently as an alternative spacer.

Is Subcision painful?

Subcision performed with a blunt cannula is generally less uncomfortable than with a sharp needle, and most patients find the procedure tolerable without anaesthetic.
When PRP is performed at the same time, anaesthetic is generally not recommended as it may affect platelet activity.

If subcision is performed with a needle or without PRP, a local anaesthetic can be used to optimise comfort.

How long is the recovery process?

After the procedure, there may be mild swelling or tenderness. Bruising is common and can take approximately 7–10 days to resolve.

How many treatments will I need?

While some improvement may be visible after a single session, multiple treatments are usually recommended to achieve optimal results.
Most patients have between 3–6 sessions, spaced 3–6 weeks apart.

Can we combine Subcision with other acne scarring treatments?

Yes, combination approaches are often recommended. Depending on the type and extent of scarring, other options may include:

  • Radiofrequency microneedling

  • Chemical peels

  • Skinboosting treatments

  • Collagen-stimulating injectables

  • TCA CROSS

  • Fractionated or full-field laser

Your practitioner will discuss which combinations are most appropriate during consultation.

Are there any contraindications to treatment?

  • History of keloid or hypertrophic scarring

  • Active infection or inflammation in the area

  • Recent (<3 months) use of oral isotretinoin

  • Pregnancy or breastfeeding

  • Use of blood-thinning medication (requires caution)

What are the possible complications?

  • Bruising

  • Haematoma formation

  • Temporary post-inflammatory hyperpigmentation (PIH)

  • Infection (rare)

  • Suboptimal response

Subcision FAQ

1. What does subcision help with?
Subcision is used to help improve the appearance of depressed or tethered scars by carefully releasing the fibrous bands beneath the skin that cause surface irregularities.

2. How long does the procedure take?
Treatment time depends on the size of the area and number of scars treated, but most sessions take around 30–45 minutes.

3. Is subcision suitable for all scar types?
Subcision is most helpful for rolling and anchored scars. Other types, such as boxcar or ice-pick scars, may require additional methods like TCA CROSS or laser for optimal results.

4. When will I see improvement?
Some improvement may be visible shortly after treatment once swelling subsides, with further refinement over the following months. Multiple sessions are often recommended.

5. What can I expect after subcision?
Mild swelling, tenderness, or bruising can occur and typically settles within one to two weeks. Most patients can resume normal activities within a few days.

6. Can subcision be combined with other procedures?
Yes. It’s often performed alongside treatments such as microneedling, laser, skinboosting, or PRP for enhanced results.

7. Is there downtime?
Downtime is generally minimal. Bruising is the most common temporary effect and can be covered with makeup after the first few days.

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