What is Subcision?

Mary McMahon

Subcision is a treatment for pitted scars where a practitioner frees the scar from the underlying tissue, allowing it to float back toward the surface of the skin and creating a smoother visual appearance. Deep acne scars are a common target for this technique, and other types of scars can be suitable candidates as well. The procedure can be done in a hospital or clinic, and some aesthetic spas have medical suites with personnel who can offer subcision and other basic treatments for severe scarring. After the site heals, people can receive skin treatments to make the scar itself smoother and less visible.

Subcision is often used on deep acne scars.
Subcision is often used on deep acne scars.

In a subcision treatment, the practitioner administers local anesthesia for patient comfort before using a fine needle to cut through the bands of fibrous tissue attaching the scar to the underlying fatty tissue. Instead of being bound to that tissue, the scar will float freely. Over time, the space underneath will fill, pushing it up to the level of the surrounding skin. People can inject a small amount of filler underneath the scar to speed this process.

Subcision can help reduce the appearance of acne scars, but care should be taken to prevent further scarring.
Subcision can help reduce the appearance of acne scars, but care should be taken to prevent further scarring.

For a mild scar, a patient may only need one treatment, while others may need multiple sessions. Patients usually notice bruising and mild pain around the site for several days after surgery, and sometimes the skin becomes discolored for several weeks. The scar will still have a rough, reddish, or shiny appearance. Treatments like microdermabrasion and peels are available to address the appearance of the scar, smoothing it out and making it less visible.

Some dermatologists may recommend noninvasive laser treatments or other resurfacing techniques before attempting subcision.
Some dermatologists may recommend noninvasive laser treatments or other resurfacing techniques before attempting subcision.

While it is not possible to completely erase a scar, procedures like subcision can make scarring less visible. People with highly visible scarring may appreciate the reduction in visibility; instead of being able to see markings from a distance, people would have to be very close to spot them. The scars may also pull and tug less at the skin, making patients feel more comfortable. Deep, large scars can cause issues like facial tightness in addition to being aesthetically unpleasing.

Facial peels may be able to address the appearance of a scar.
Facial peels may be able to address the appearance of a scar.

People who want to receive subcision treatments or other scar therapies can meet with a dermatologist to discuss options. The doctor will evaluate the patient, considering the history of the scarring and its appearance, and make recommendations for treatments. Costs vary, and may not always be covered by insurance benefits unless there is a compelling medical reason to treat the scarring. Patients concerned about cost can check with insurers first and discuss payment plans and other options for covering the cost of care.

Subcision on deep acne scars may be performed in a hospital or clinic.
Subcision on deep acne scars may be performed in a hospital or clinic.
Acne is typically considered a normal part of puberty.
Acne is typically considered a normal part of puberty.

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