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Subcision

Surgical technique for fixed atrophic scars

Duration
30-45 min
Downtime
3-7 days
Sessions
3-6 sessions (4-8 wk intervals)

About This Treatment

Subcision treats fixed atrophic depressed scars (tethered acne scars) by surgically severing sub-epidermal fibrotic attachments. Special needle physically breaks fibrous connections causing depression. Subsequent fibroblast activation rebuilds collagen, lifting scars. Particularly effective for deep scars resistant to fractional laser/microneedling.

Mechanism of Action

18-20G special needle inserted beneath scar tissue (dermis-subcutaneous) to deliberately sever fibrous septae causing depression. Creates local trauma triggering fibroblast activation. Rapid collagen remodeling lifts scar; elevation improves depression. Multiple sessions provide cumulative benefit.

Indications

AcneAcne scars / scars

Expected Results

40-60% crater improvement after 3-6 sessions. Tethered scars show dramatic improvement with multiple treatments. Complete elimination difficult but marked improvement in visibility. Fractional laser+subcision combination more effective.

Clinical Evidence

Orentreich DS, Orentreich N (1995)
Subcutaneous incisionless (subcision) surgery for the correction of depression and elongated scars. Dermatol Surg
Clinical improvement was reported in this study (see original paper for details).
Alam M, Omura NE, Gold MH, et al. (2020)
Subcision and other treatments for depressed scars. Dermatol Surg
Clinical improvement was reported in this study (see original paper for details).

Risks & Side Effects

Redness/swelling (3-7 days), bruising (resolves 1-2 weeks), pain (mitigated by anesthesia). Rare infection. Theoretical scarring risk minimal with proper technique. Nerve injury very rare.

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