Yes, subcision with suction improved atrophic acne scars more than subcision alone in an October 2026 split-face trial. Subcision is a procedure that releases depressed scars by cutting tight fibers beneath the skin, and added suction holds the lifted skin up during early healing. Both treatment sides improved significantly in the trial. The suction-treated side earned significantly higher doctor-rated and patient-rated improvement scores.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- How suction helps subcision work
- What the 2026 trial found
- Why the suction schedule matters
- Are you a candidate and what are the downsides?
How suction helps subcision work
Subcision cuts fibrous tethers under depressed scars and stimulates fibroblast activity for new connective tissue. Added suction mechanically lifts the scar during healing and helps prevent early reattachment and redepression, according to the Dove Medical Press review in the Clin Cosmet Investig Dermatol review. Patients apply simple at-home vacuum suction during the redepression window, reported as 2-5 to about 17 days after subcision.
The goal is to prolong pocket healing and support connective-tissue buildup under the scar. This approach best suits rolling or tethered depressed scars. Active acne should be controlled before treatment, according to the MDedge Dermatology report.
What the 2026 trial found
The October 2026 randomized split-face trial treated one facial side with subcision alone and the other side with subcision plus suction. Both sides showed significant improvement in atrophic acne scars. Physician-rated and patient-rated Acne Scar Improvement Grading Scale scores were significantly higher on the suction side, with p=.002 and p=.026 respectively, according to the U.S.
National Library of Medicine PubMed record in the PubMed summary. The same trial concluded that the subjective advantage was not fully captured by objective scar-counting methods. That points to a clinically visible benefit that scar counts alone missed.
Why the suction schedule matters
An earlier Harandi et al. study treated 58 patients with rolling, boxcar, pitted, chickenpox, traumatic and surgical depressed scars. Among 46 fully adherent patients, scar depth and size improved 60-90%, with a mean of 71.73%.
The protocol started suction on day 3 after subcision and continued at least every other day for 2 weeks. Twelve patients who used suction late or infrequently gained only 30-60%, with a mean of 43.75%, according to the R Discovery record of the journal article. Regular suction during the first two weeks therefore appears central to the result. Missed or delayed sessions were linked to substantially smaller gains.
Are you a candidate and what are the downsides?
A Northwestern split-face evaluator-blinded trial tested one subcision on both sides plus 10 suction sessions on one side in adults with bilateral acne scars. That study excluded people with recent isotretinoin use and people with keloid history, according to the Research Square preprint by Northwestern authors.
A 2023 comprehensive review found only one published adjuvant-therapy study supporting suction and called for more data. Subcision also carries bruising, hematoma, nodule and pigment-change risks, according to the NIH review in the PMC review.
- Ask whether your scars are rolling or tethered depressed scars
- Confirm active acne is controlled before subcision
- Mention isotretinoin use, keloid history, and pigment-change risk
- Plan for bruising downtime and every-other-day suction visits
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