Subcision for Acne Scars

Subcision is a minimally invasive surgical procedure designed to treat rolling scars, boxcar scars, as well as depressed or atrophic acne scars. These scars develop when the skin’s underlying support structure is damaged, leading to visible indentations on the skin’s surface.

During the treatment, a doctor uses a small needle to release the fibrous bands beneath the skin that are pulling the surface downwards. Breaking these bands helps to immediately elevate the depressed scar while also stimulating collagen production.

This process results in a smoother, more even skin surface. Subcision is a recognised and generally safe approach for enhancing skin texture and reducing the visibility of acne scars.

Please note that these are general guidelines, and individual experiences may vary. Contact Dr Gerard Ee for a personalised consultation.

The principle of subcision involves using a small needle to break the fibrotic strands that tether the scar to the underlying subcutaneous tissue, creating its depressed appearance. By releasing these strands, the depression is lifted, and the skin’s natural healing process can begin.

The treatment usually starts with cleaning the patient’s skin thoroughly to remove any dirt or makeup. A topical numbing cream will then be applied to the treatment area before a local anaesthetic is injected to ensure comfort.

The needle is then carefully inserted under the skin and moved back and forth in a fanning motion. The sharp edges of the needle gently cut the fibrous scar tissue, detaching the scar from the deeper tissue.

Sometimes, a snapping sound may be heard as these bands break. This is the release that allows the sunken skin to rise. After the treatment, the needle is removed, and gentle pressure is applied around the entry point to remove any excess blood and minimise bruising.

As the wound heals, collagen production will be stimulated, leading to new collagen deposition, which gradually fills in the depressed area and improves the scar’s appearance. Subcision is particularly helpful for rolling and boxcar acne scars, which are characterised by this type of tethering.

In some cases, where the treated area is small, the resulting blood clot may not be large enough to prevent the untethered skin from healing. As such, Dr Gerard Ee may advise to inject fillers or collagen stimulators to optimise the effectiveness of the treatment and ensure patient satisfaction. These injectables provide additional support and volume, reducing the risk of the scar re-attaching to the underlying tissue.

At Dr Gerard Ee’s clinic, patients can expect a subcision procedure conducted with professionalism and personal care. Dr Ee’s approach combines a thorough understanding of skin anatomy with techniques to address acne scars.

Personalised Scar Mapping & Technique Selection

Each subcision appointment begins with a detailed consultation and thorough scar assessment. Following this evaluation, and once the scars are determined to be suitable for subcision acne scar treatment, Dr Ee will formulate a comprehensive plan.

This includes selecting the optimal technique and appropriate instruments, carefully determining the entry points, and considering the potential benefits of combining subcision with other acne scar treatments, such as fillers or lasers,  to achieve the most effective outcome.

Subcision with Surgical Care

Depending on the type and location of the scar, Nokor needles or blunt-tipped cannulas may be used to perform the subcision procedure. During the treatment, the needle is inserted with control, at a specific depth, and in a predetermined direction. The needle will then be moved in a fanning or sweeping motion under the scar tissue to deliberately break the fibrous bands. This minimises trauma and other potential side effects.

Consideration for Asian Skin

Dr Gerard Ee is experienced in addressing the unique characteristics of Asian skin, which can include a tendency for a thicker dermis and stronger inflammatory responses. He will employ gentler entry angles and minimally traumatic techniques during subcision, limiting tissue damage in Asian patients.

While subcision may help treat deeper acne scars, it may not address surface-level irregularities, pigmentation changes, or volume loss on its own. To optimise the results, Dr Gerard Ee may recommend combining subcision with other acne scar treatments to address different aspects of scarring.