Subcision

Subcision is one of the modern and effective methods for treating deep scars and acne marks, which has gained significant popularity among doctors and patients in recent years. This non-surgical technique is designed to improve the skin's texture and restore its natural appearance. Subcision is typically used to treat depressed scars, old acne marks, and even some stubborn wrinkles.

In this method, the physician uses a special and very fine needle known as a cannula or a subcision-specific needle to target the underlying layers of the skin. This needle is inserted into the skin and cuts the fibrotic bands that cause the pulling and indentation of scars or acne marks. The result of this process is the release of the skin tissue and stimulation of collagen production, which leads to the filling and smoothing of the treated area.

One of the major advantages of subcision is that it does not require a long recovery period, and individuals can usually return to their daily activities immediately. However, some redness, swelling, or bruising may appear in the treated area after the procedure, which is normal and usually subsides within a few days.

Subcision is a completely safe procedure, but choosing a skilled and experienced specialist is very important. Performing this method by unqualified individuals may lead to further damage, so it is essential to visit reputable clinics and experienced doctors.

This method is often combined with other treatments such as microneedling, fractional laser, or filler injections to achieve better results. Combining these treatments can accelerate skin tissue improvement and provide longer-lasting outcomes.

Given the importance of this matter, it is recommended to consult your doctor before undergoing subcision and clearly express your expectations to achieve the best possible results.

Subcision is an effective method for treating deep scars and acne marks, but like any medical treatment, it is not suitable for everyone. Understanding who the best candidates for this procedure are can help you make an informed decision about your treatment.

Individuals who are ideal candidates for subcision include:

• Those with deep or depressed acne scars:
  People whose scars appear as deep indentations or tethered areas of skin often benefit most from subcision. This technique is specifically designed to release fibrotic bands that pull the skin downward.

• Those with scars from surgery or injury:
  Individuals with noticeable scars caused by surgery, accidents, or trauma that have affected their skin's appearance may be good candidates for this procedure.

• Those with healthy skin and no active infections:
  Subcision is most effective for people who have generally healthy skin and are free from active infections, ongoing acne breakouts, or specific skin conditions in the treatment area. The presence of infection or inflammation can interfere with the healing process.

Who is not a suitable candidate for subcision?

• Individuals with active acne or infections in the treatment area

• Those with chronic skin conditions such as psoriasis or eczema affecting the target area

• People who have recently undergone skin treatments like deep chemical peels or laser resurfacing and whose skin has not fully healed

• Pregnant or breastfeeding women, unless explicitly advised otherwise by a qualified physician

It’s important to consult with a medical professional to evaluate your specific case and determine whether subcision is appropriate for you.

Subcision is a modern and effective technique for treating deep scars and acne marks. However, like any other treatment method, it has both advantages and disadvantages that should be carefully considered before making a decision.

Advantages of Subcision

• Significant improvement in deep scars and acne marks:
  Subcision is specifically designed to treat deep, depressed scars caused by acne, and it generally yields satisfying results.

• Long-lasting effects:
  This method stimulates collagen production in the skin, which can gradually improve skin texture and deliver long-term benefits.

• Non-surgical and minimally invasive procedure:
  Subcision is performed using a fine needle without the need for surgery, resulting in a shorter recovery time compared to surgical methods.

• Short recovery period:
  Most individuals can return to their normal daily activities within a few days after the procedure.

• Can be combined with other treatments:
  Subcision is often used alongside microneedling, fractional laser treatments, or dermal filler injections to enhance overall results.

• More cost-effective than cosmetic surgery:
  Compared to more invasive and expensive surgical options, subcision is a more affordable choice for treating skin imperfections.

Disadvantages of Subcision

• Temporary bruising and swelling:
  After the procedure, bruising, redness, or swelling may occur in the treated area, which is normal and typically resolves within a few days.

• May require multiple sessions:
  Depending on the severity of the scars or acne marks, several treatment sessions may be necessary to achieve the desired outcome.

• Gradual results:
  Final results from subcision may take several weeks or even months to become noticeable, as collagen production is a slow process.

• Risk of infection or inflammation:
  If performed by unqualified individuals or if post-treatment care is neglected, there is a risk of infection or inflammatory reactions.

• Not effective for all types of scars:
  Subcision is primarily effective for depressed scars and may not yield satisfactory results for raised or hypertrophic scars.

Before undergoing subcision, it’s important to consult with a qualified dermatologist or aesthetic specialist to determine if this treatment is appropriate for your skin condition and expectations.

Subcision is a precise and specialized technique performed by a qualified dermatologist or aesthetic physician. It is designed to deliver the best possible results with minimal invasiveness. The procedure generally follows these steps:

1. Consultation and Skin Assessment

• The physician begins with a consultation to assess the patient's skin condition.

• The type and severity of acne scars or wounds, as well as the patient's treatment goals, are carefully evaluated.

2. Preparation of the Treatment Area

• The skin is thoroughly cleansed and disinfected to prevent any risk of infection.

• In some cases, a topical numbing cream or local anesthetic injection is applied to minimize discomfort during the procedure.

3. Insertion of the Subcision Needle

• A special, very fine needle (usually a cannula or Nokor needle) is used.

• The needle is gently inserted into the skin, reaching the subdermal layer beneath the scar.

• Fibrotic bands tethering the skin down are carefully broken with controlled movements of the needle.

4. Release of Underlying Tissue

• Once the fibrotic bands are severed, the tissue is released, and the depressed appearance of the scar begins to improve.

• This process also stimulates collagen production, which gradually helps repair and fill in the scar over time.

5. Use of Complementary Treatments (If Needed)

• Depending on the severity of the condition, additional treatments such as dermal filler injections, microneedling, or fractional laser therapy may be applied post-subcision.

• These combination therapies can accelerate healing and enhance the final outcome.

6. Completion and Post-Treatment Care

• After the procedure, the treated area is disinfected again. Antibiotic or healing creams may be applied if necessary.

• The patient receives specific aftercare instructions, which typically include:

  • Avoiding direct sun exposure

  • Using sunscreen and moisturizers

  • Refraining from applying harsh skincare products for a few days

Duration of the Procedure

Each subcision session usually takes between 30 to 60 minutes, depending on the number and severity of the scars being treated.

Recovery Period

After subcision, some swelling, bruising, or redness may occur, which typically subsides within a few days.

Proper post-treatment care and following your doctor’s recommendations can significantly impact the effectiveness and safety of the procedure.

The longevity of subcision results can vary from person to person, depending on several factors. However, the outcomes are typically long-lasting, and in many cases, permanent—provided that proper post-treatment care is followed and negative influences on the skin are well managed.

Key Factors Influencing the Longevity of Subcision Results

Here are five major factors that affect how long subcision results will last:

1. Type and Severity of Scars or Acne Marks

• Deeper and more severe scars may require multiple treatment sessions. Once the full treatment is completed, results tend to be long-term.

• Shallow scars usually respond faster and often yield permanent results after fewer sessions.

2. Age and Skin Type

• Younger and healthier skin typically produces collagen more efficiently, leading to longer-lasting improvements.

• People with slower collagen production or skin prone to damage might need occasional maintenance sessions.

3. Post-Treatment Care

• Using prescribed creams, applying sunscreen, and avoiding sunburn or irritating products are crucial for maintaining results.

• Neglecting aftercare can reduce the durability of the treatment effects.

4. Ongoing Collagen Production

• Since subcision stimulates collagen production, the skin often continues to improve over time.

• Combining subcision with complementary treatments like microneedling or laser therapy can help maintain collagen production and prolong results.

5. Lifestyle and Environmental Factors

• A healthy lifestyle—balanced diet, regular exercise, and avoiding smoking—supports better skin healing and collagen maintenance.

• Factors like stress, pollution, and poor skincare habits can negatively affect how long the results last.

Is Subcision Permanent?

In many cases, yes, the results of subcision can be permanent. This is because the fibrotic bands tethering the skin are physically released, and the tissue undergoes remodeling. However, additional sessions might be necessary in the following situations:

• If new scars or acne lesions form

• If active skin conditions like acne reappear

When Will You See Results?

• Initial effects of subcision are often noticeable within a few weeks.

• Final results typically become evident within 3 to 6 months, as collagen continues to build and improve the skin’s texture over time.

To achieve and preserve the best possible outcome, regular follow-ups with your dermatologist and adherence to skincare guidance are highly recommended.

Subcision is a non-surgical, minimally invasive procedure that is generally considered safe. However, like any medical treatment, it can involve certain side effects. Most of these are mild and temporary, but being aware of them can help you make an informed decision and manage any symptoms effectively if they occur.

Common and Temporary Side Effects

• Bruising:
  This is one of the most common side effects of subcision. It occurs due to the movement of the needle under the skin and usually resolves within 7 to 10 days.

• Swelling:
  Mild to moderate swelling in the treated area is normal and typically subsides after a few days.

• Redness:
  Redness may persist in the treated area for a few days but gradually fades.

• Pain or Discomfort:
  Some patients may experience pain or tenderness in the treated area after the procedure. This can usually be managed with prescribed pain relievers or rest.

Rare but Possible Side Effects

• Infection:
  If the area is not properly disinfected or post-treatment care is neglected, an infection may develop. Prescribed antibiotic creams can help prevent this.

• New Scars or Wounds:
  In very rare cases, improper technique or overly sensitive skin may lead to the formation of new scars.

• Fluid Accumulation (Hematoma):
  Blood or fluid may collect under the skin due to damage to blood vessels. This usually resolves on its own, but in some cases, medical drainage may be required.

• Temporary Numbness or Altered Sensation:
  Minor damage to superficial nerves may result in numbness or unusual sensations in the treated area. This is typically temporary and resolves over time.

Conclusion

While subcision is a relatively low-risk procedure, it is essential to:

• Choose an experienced and certified practitioner

• Follow all aftercare instructions carefully

• Monitor the treated area for any unusual symptoms

If you experience any severe or persistent side effects, consult your doctor promptly.

Proper care before and after subcision plays a crucial role in the effectiveness of the treatment and minimizing side effects. Following these guidelines will help your skin heal faster and reduce the risk of complications.

Pre-Subcision Care

1. Avoid Blood-Thinning Medications

   • Refrain from using medications such as aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) at least one week prior to treatment (only after consulting with your doctor).

   • These medications increase the risk of bleeding and bruising.

2. Avoid Smoking and Alcohol

   • At least one week before the procedure, avoid smoking and alcohol, as they can delay the healing process and increase the chance of side effects.

3. Avoid Other Aggressive Skin Treatments

   • Do not undergo other procedures like laser treatments, chemical peels, or microneedling shortly before subcision, as they may irritate the skin and reduce subcision's effectiveness.

4. Maintain Skin Hygiene

   • Keep your skin clean in the days leading up to the procedure.

   • Avoid heavy makeup and skincare products that might cause irritation or clogging.

Post-Subcision Care

1. Rest and Avoid Intense Activities

   • Refrain from heavy physical activity or intense workouts for a few days. These can aggravate swelling and prolong recovery. Rest is recommended during the initial recovery period.

2. Use Sunscreen and Protect Your Skin

   • Skin is more sensitive after subcision. Use a broad-spectrum sunscreen with SPF 30 or higher, even on cloudy days, to protect from UV damage.

3. Avoid Sun Exposure

   • For at least two weeks, avoid direct sun exposure. If you must go outside, use a wide-brimmed hat, sunglasses, and sunscreen.

4. Apply Prescribed Creams and Antibiotics

   • Your doctor may prescribe topical antibiotics or anti-inflammatory creams to prevent infection and reduce inflammation. Use them exactly as directed.

5. Avoid Touching or Massaging the Treated Area

   • Do not touch, press, or massage the treated area for a few days to avoid irritation, inflammation, or complications.

6. Manage Bruising and Swelling

   • If you notice bruising or swelling, apply a cold compress to the area.

   • Over-the-counter pain relievers like acetaminophen can help manage discomfort (avoid NSAIDs unless approved by your doctor).

7. Keep the Area Clean

   • Cleanse the treated area gently with cool water and fragrance-free cleansers.

   • Avoid heavy cosmetic or skincare products for several days.

8. Avoid Irritating Skincare Products

   • For the first few weeks, do not use retinoids, fruit acids (AHA/BHA), exfoliants, or any other harsh skincare ingredients. These can disrupt healing and irritate the skin.

Final Tips

• Always follow your doctor’s specific instructions tailored to your skin type and treatment plan.

• Stick to a gentle skincare routine and avoid any activities or products that may stress or damage your healing skin.

• If you notice unusual symptoms like severe pain, pus, or prolonged redness/swelling, contact your doctor immediately.

With careful pre- and post-care, subcision can yield excellent results and a smooth, effective recovery.

Subcision is an effective treatment for improving depressed scars and acne marks, and it can be performed on individuals across various age groups. However, the ideal age for undergoing this treatment depends on skin condition, healing capacity, and treatment goals. Below is a breakdown of how suitable subcision is for different age ranges:

Young Adults (Ages 18–30)

• Common Concerns:
  The most frequent reason for subcision in this age group is to treat acne scars—especially those left behind after severe or chronic acne.

• Suitability:
  Younger skin typically has better collagen regeneration and faster healing, which means results are often quicker and more successful.
  Most individuals in this age range are physically healthy and tolerate the procedure well.

Middle-Aged Adults (Ages 30–50)

• Common Concerns:
  Individuals may seek treatment for old acne scars or fine lines and early wrinkles.

• Results:
  Although collagen production starts to decline gradually after 30, the skin still responds well to collagen stimulation.
  Those in their late 40s may need multiple sessions or combined treatments for optimal results, but subcision remains effective.

Older Adults (Ages 50 and Above)

• Common Concerns:
  At this stage, subcision can address deep wrinkles, volume loss, and long-standing acne scars.

• Considerations:
  Skin repair is slower due to reduced collagen production. Results may take longer to appear, and improvements might be more subtle than in younger patients.

• Combination Treatments:
  For this age group, subcision is often performed alongside dermal fillers, laser treatments, or microneedling to maximize skin rejuvenation and improve overall texture.

Conclusion

There is no strict age limit for subcision. However:

• Ages 18–30: Ideal for treating acne scars with fast and effective results.

• Ages 30–50: Still excellent for both scars and early aging signs, though may require more sessions.

• Ages 50+: Effective when combined with complementary treatments, with results appearing more gradually.

Regardless of age, a thorough consultation with a dermatologist is essential to evaluate skin health, set realistic expectations, and create a tailored treatment plan.

Subcision is one of several effective options for treating acne scars and skin irregularities. However, its effectiveness and use vary compared to other methods depending on the depth and type of scarring. Here’s a clear comparison with other common treatments:

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Subcision vs. Fractional Laser

Aspect	Subcision	Fractional Laser
Mechanism	Breaks fibrotic bands beneath the skin	Stimulates collagen through controlled laser-induced damage
Best For	Deep, tethered acne scars	Surface-level issues like fine lines, pigmentation, mild scars
Downtime	Shorter recovery time (few days)	Longer downtime (redness and peeling for several days)
Effectiveness on Deep Scars	High	Moderate – may require more sessions

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Subcision vs. Microneedling

Aspect	Subcision	Microneedling
Mechanism	Physically breaks scar tissue under the skin	Creates controlled micro-injuries to stimulate collagen
Best For	Deep, indented acne scars	Mild textural issues, enlarged pores, fine lines
Invasiveness	More invasive (requires a special needle)	Minimally invasive
Effectiveness on Deep Scars	High	Low to moderate

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Subcision vs. Dermal Fillers

Aspect	Subcision	Fillers
Mechanism	Stimulates natural collagen production	Temporarily fills in depressions
Results	Gradual and long-lasting	Immediate but temporary (typically 6–18 months)
Best For	Deep acne scars with tethering	Quick correction of volume loss and scar depressions
Risks	Low when done by a professional	May cause lumps, allergic reactions, or require regular upkeep

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Summary

• Subcision is ideal for deep, tethered scars and provides a natural, long-term improvement.

• Fractional laser is better suited for surface texture issues and pigmentation.

• Microneedling is effective for general skin rejuvenation and mild scarring.

• Dermal fillers offer instant results but are temporary and often best used in combination with subcision.

In many cases, the best outcomes come from combining subcision with one or more of these treatments, tailored to your skin's needs. Always consult with a dermatologist for a customized treatment plan.

One of the major advantages of subcision is its ability to be effectively combined with other dermatological treatments to enhance outcomes. By tailoring a combination approach, dermatologists can address both deep and superficial skin issues, leading to faster healing and more noticeable, long-lasting results. Here’s how subcision pairs with other popular treatments:

1. Subcision + Fractional Laser

Why Combine Them?

• Subcision works at a deeper level, breaking fibrotic bands beneath the skin.

• Fractional laser enhances surface skin quality, reducing pigmentation, fine lines, and stimulating additional collagen production.

Benefits of the Combination:

• Targets both deep acne scars and surface imperfections (like spots, fine wrinkles, and texture issues).

• Boosts overall skin regeneration, tone, and texture.

• Results in more comprehensive improvement than either treatment alone.

Key Notes:

• These treatments are typically performed in separate sessions.

• Usually, subcision is done first, followed by fractional laser after the skin has healed (often 3–6 weeks later).

2. Subcision + Microneedling

Why Combine Them?

• Subcision releases deep fibrous scar tissue, while microneedling induces micro-injuries that trigger collagen production in the upper and middle dermis.

• This pairing addresses both the structure and surface of the skin.

Benefits of the Combination:

• Enhances collagen stimulation and accelerates skin remodeling.

• Microneedling may improve absorption of serums or PRP (Platelet-Rich Plasma) used during or after treatment.

• More effective for deep scars with surrounding textural issues.

Key Notes:

• May require longer recovery time.

• Should only be done under expert supervision to prevent irritation or complications.

3. Subcision + Dermal Fillers (e.g., Hyaluronic Acid)

Why Combine Them?

• Subcision addresses the root cause of depressed scars by freeing tethered tissue.

• Fillers immediately lift and smooth the area by restoring lost volume.

Benefits of the Combination:

• Immediate and visible improvement from fillers combined with the long-term benefits of subcision.

• Ideal for deep atrophic scars that may not fully elevate with subcision alone.

Key Notes:

• Fillers are temporary (typically lasting 6–18 months).

• Subcision has longer-lasting or even permanent results in many cases.

• Often used together to enhance both speed and quality of the outcome.

Conclusion: A Personalized Approach

Combining subcision with other skin treatments allows for customized solutions based on individual skin needs:

Concern	Best Combination
Deep acne scars	Subcision + Fillers or Fractional Laser
Scarring + texture irregularity	Subcision + Microneedling
Scarring + pigmentation/wrinkles	Subcision + Fractional Laser
Immediate volume + long-term result	Subcision + Fillers

Always consult a qualified dermatologist before combining treatments. The timing, sequence, and technique used are crucial for minimizing risks and maximizing benefits.

The recovery period following subcision is generally short and manageable, but it plays a crucial role in determining the final outcome of the treatment. With proper aftercare, you can accelerate healing and minimize side effects.

Typical Recovery Timeline

• Initial side effects like swelling, bruising, and redness are common and expected, particularly within the first few days.

• Most people can return to daily activities within 1–2 days, although complete cosmetic recovery takes a bit longer.

Breakdown of Symptoms and Duration

Symptom	Typical Duration	Details
Swelling	2–3 days	Usually mild to moderate and begins to subside quickly.
Bruising	5–7 days	May appear immediately or develop within a day. Can vary by individual.
Redness	2–5 days	Mild redness may linger but typically fades without intervention.

Key Tips for a Smoother Recovery

• Use cold compresses in the first 24–48 hours to reduce swelling and bruising.

• Avoid strenuous activity and heavy exercise for at least 2–3 days to prevent worsening of symptoms.

• Keep the treated area clean and avoid applying makeup or harsh skincare products for the first few days.

• Follow your doctor's aftercare instructions, including any prescribed topical creams or antibiotics.

• Protect your skin from the sun by using a broad-spectrum SPF and avoiding direct exposure.

When to Seek Medical Advice

While side effects are usually temporary, contact your doctor if you experience:

• Persistent pain or swelling beyond 7–10 days

• Signs of infection (e.g., warmth, pus, fever)

• Unexpected changes in skin color or texture

In summary, the downtime for subcision is minimal, with most visible effects resolving within a week. Good skincare, sun protection, and rest can significantly enhance the healing process and help you get the best results.

1. Is subcision covered by insurance?

No, subcision is generally not covered by insurance, as it is considered a cosmetic procedure. For accurate details, it’s best to consult your insurance provider.

2. Can subcision be performed during pregnancy or breastfeeding?

It is not recommended to undergo subcision during pregnancy or while breastfeeding, due to limited safety data and the potential use of numbing agents or medications.

3. What results can I expect from subcision?

You can expect noticeable improvement in the appearance of scars and a smoother skin texture. Temporary swelling and bruising are normal, and final results typically appear within 3 to 6 months as collagen builds.

4. Is subcision painful?

Subcision is usually performed under local anesthesia, so the procedure itself involves minimal pain. Some discomfort, tightness, or swelling may be experienced afterward but is generally mild and manageable.

5. What is the recovery time after subcision?

Recovery is relatively quick. Most people can return to normal activities within 2 to 3 days, though bruising or swelling may last up to a week.

6. Are multiple sessions necessary?

Often, one session is sufficient, especially for mild to moderate scarring. However, some individuals may require additional sessions depending on the depth and severity of their scars.

7. Is subcision a safe and approved procedure?

Yes, subcision is a clinically proven, safe, and approved treatment, but it must be performed by a qualified dermatologist or trained medical professional.

8. Do I need any special tests or evaluations before the procedure?

Generally, no special tests are required before subcision. However, if you have pre-existing medical or skin conditions, your doctor may conduct an evaluation to ensure it’s safe for you.