Subcision Acne Scar​
How does subcision work?
One primary mechanism involves disrupting the fibers that tether the scar downward. Additionally, the physical scraping beneath the dermis is believed to trigger the generation of new collagen, thereby aiding in scar elevation.
What are the advantages of subcision?
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Subcision stands out as the sole procedure capable of lifting scars tethered by the acne scarring process. Consequently, it enhances rolling and boxcar acne scars, with potential improvements ranging from 10% to 50%.
What are the potential risks associated with subcision?
As with any surgical intervention, there are inherent risks to consider, although they are typically infrequent. The primary risk involves bruising, with possible occurrences of bleeding and hematoma formation. However, utilizing tumescent anesthesia significantly mitigates these risks. Temporary numbness in treated areas is common but usually resolves within 2 to 4 months, while permanent numbness is rare.
Less common risks encompass:
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Nerve damage resulting in muscle weakness (a rare complication)
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Infection
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Formation of collagen nodules under the skin, usually self-resolving but occasionally requiring intervention
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Scarring, including hypertrophic or keloid scarring at the entry site or subcision areas
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Changes in skin coloration
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Persistent swelling and lymphedema
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Reports of sagging​
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It's important to note that a specific degree of improvement cannot be guaranteed, and in some cases, minimal improvement may occur.
Q&A
What is the recovery time after subcision?
With cannula subcision, any resulting bruising typically resolves within 2 to 7 days, allowing most individuals to return to work the next day for small areas. However, with tumescent anesthesia and larger treatment areas, facial puffiness may persist for up to two days, with a potential one-week recovery period. Most individuals can resume work within two days after tumescent anesthesia.
How many sessions of subcision are typically required?
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The necessity for repeated sessions of cannula subcision varies depending on the severity and extent of scarring, with an average of 2 to 3 sessions for most patients.
When is the optimal time for subcision if other treatments are planned?
Subcision can be combined with procedures such as TCA cross and punch excision of acne scars. However, Tixel or laser resurfacing is typically scheduled at least three weeks post-subcision.
Can subcision suffice as the sole treatment for acne scars?
In some instances, a series of subcision sessions may be sufficient as a standalone treatment. However, it's more common for subcision to be part of a comprehensive treatment plan that includes other modalities like TCA Cross and various laser resurfacing techniques to address different types of scars and enhance overall skin texture.
How soon can the effects of subcision be observed?
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While some immediate improvements may be noticeable, the full results of subcision typically manifest within 2 to 4 months post-treatment. Further enhancements may continue for up to a year as scar tissue undergoes remodeling.
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