The 2026 split-face trial found both subcision alone and subcision with suction improved atrophic acne scars, but suction-treated sides earned higher physician and patient scores. Objective scar counts missed part of that benefit, while rating scales captured a visible difference patients could see.
Subcision is a procedure that releases tethered bands pulling pitted scars downward. Atrophic acne scars are depressed scars that remain after acne heals. The trial tested whether adding suction after subcision keeps the released skin lifted longer.
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 the split-face comparison worked
- Why patient scores beat scar counts
- Who may notice the most change
- What treatment involves in practice
- Frequently Asked Questions
How the split-face comparison worked
Each participant served as their own control. Both cheeks received cannula subcision, then one randomly chosen side received 10 suction sessions while the other received sham pressure in a patient-blinded comparison, according to the Research Square preprint full text read the preprint full text. The published report was a randomized split-face clinical trial comparing subcision alone against subcision with suction, listed in the October 2026 Dermatologic Surgery journal listing see the Dermatologic Surgery journal listing. It enrolled 27 people with scars on both sides of the face.
That small size limits how broadly the results apply. Short follow-up is another limit. A related pilot analysis covered 28 treatment areas. Longer studies are needed to judge durability beyond a few months.
Why patient scores beat scar counts
Both treatments produced measurable benefit. The gap appeared on graded improvement, not simply on whether scars were present. Physician-rated and patient-rated Acne Scar Improvement Grading Scale scores were significantly higher on the suction side, at p=.002 and p=.026 respectively, according to the U.S. National Library of Medicine/PubMed abstract read the PubMed abstract for the 2026 trial.
The investigators concluded subjective assessments favored suction-assisted subcision, pointing to perceptible benefits not fully captured by scar counting. A related rater-blinded split-face analysis showed the same pattern. Dermatologist raters found no difference at 1 and 4 months, while subjects rated suction higher at 1 month by 37% versus 24%. By 4 months, the subject-rated gap was no longer significant.
Who may notice the most change
Atrophic scars include icepick, boxcar, and rolling types. Icepick scars are narrow and deep. Boxcar scars have sharper edges, while rolling scars are wider and tethered. Reviews find subcision improves all three types but works best for tethered rolling scars.
That matters because release of the tether allows the depression to lift. Suction may help maintain that lift during early healing. People with mainly rolling scars on both cheeks match the trial design most closely. Those with mainly icepick scarring may need combination treatment. A dermatologist can map scar types before recommending subcision.
What treatment involves in practice
Suction is proposed to prevent early redepression that begins 2 to 5 days after subcision. Repeat suction sessions hold the freed tissue away from its base. The trial used 10 sessions on the active side. Expect temporary bruising, swelling, edema, or redness for days to 2 weeks.
Less-common effects include nodules or pigmentation change. These effects usually resolve without lasting harm. Plan time off for swelling if your work involves close contact. Take dated photos in the same light to track change.
- Ask what scar types dominate your cheeks
- Ask how many suction visits the clinic uses
- Ask what aftercare reduces bruising and pigmentation risk
- Ask what follow-up timing the clinic uses to judge results
Frequently Asked Questions
Does subcision alone still help?
Yes. Both sides improved in the 2026 trial, so subcision alone produced measurable benefit without suction.
How soon could I judge the added effect?
Patient-rated differences were clearest at one month in the related analysis and faded by four months, so ask your clinic when to reassess.
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- Subcision With Suction for Acne Scars in a 2026 Split-Face Trial: What the Trial Means for People With Atrophic Acne Scars
- The 160-Participant Acne Scar Combination Trial Published in 2026: What the Trial Means for People With Atrophic Acne Scars
- Subcision With Suction for Acne Scars: Objective and Patient-Rated Results in 2026