Objective scar counts measure number and grade, while patient ratings measure visible smoothness and satisfaction. In the October 2026 subcision trial, both methods improved rolling scars, but patient and doctor global ratings favored suction-assisted subcision more clearly than scar counts alone.
Subcision means a doctor places a needle under the skin to cut tight bands that pull the surface down. Rolling scars are wide, shallow dips caused by that tethering. The 2026 trial treated both cheeks with subcision and added 10 suction sessions to one side to test prevention of early re-tethering, according to Dermatologic Surgery via Ovid as listed in the PubMed trial record.
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
- What did the 2026 trial actually test?
- Why did ratings show more than scar counts?
- How large is the suction benefit?
- How can you compare acne scar procedures?
What did the 2026 trial actually test?
Both facial sides received subcision for atrophic acne scars, so the release procedure itself did the main work. One side then received suction intended to hold the released tissue apart during early healing. PubMed reports both subcision alone and subcision-plus-suction significantly improved atrophic scars.
Physician-rated and patient-rated Acne Scar Improvement Grading Scale scores were significantly higher on the suction-treated side. The p-values were .002 for physician ratings and .026 for patient ratings. The scale grades overall improvement, not single scar counts.
Why did ratings show more than scar counts?
Scar counts record each pit, while global ratings judge texture, shadow, and overall appearance. The trial authors concluded subjective assessments favored suction-assisted subcision, suggesting smoother appearance that scar counting missed. PubMed presents this as a clinically perceptible benefit rather than proof of permanent structural change.
A separate rolling-scar study supports that link between measured change and lived appearance. Springer Medizin lists a split-face, evaluator-blinded study where multiple subcision produced a larger drop in global scarring scores and a larger baseline-to-Week-36 appearance change than the untreated side, described in the Springer Medizin study listing. In that study, 50% of patients reported greater overall satisfaction with the multiple-subcision side than the control side.
How large is the suction benefit?
Expect a modest add-on effect, not a new result level. A split-face subcision-with-suction preprint found no significant lasting objective difference versus subcision alone, with only a temporary incremental benefit detected by patients. Research Square hosts that preprint finding.
This matters for cost and time decisions. Ten suction visits add appointments, bruising risk, and aftercare. People with rolling or tethered scars can still expect benefit from the release itself rather than only from suction.
How can you compare acne scar procedures?
Use the same yardstick the trials use. Ask whether the result was judged by blinded doctors, by patients, or by both. Ask which scale was used and at what month, since early swelling can hide or mimic improvement.
- Compare release procedures by patient satisfaction and appearance scores, not only scar counts.
- Compare energy and resurfacing options by published review data: a PeerJ network meta-analysis of 68 trials with 4,480 patients found laser-plus-PRP best for ECCA-score reduction, laser-plus-filler best for Goodman-Baron reduction, laser-plus-peel best for satisfaction, and microneedling most tolerable for pain, as reported in the PeerJ network meta-analysis.
- Compare burden by sessions, healing days, pigment-change risk, and need for repeat treatment.
- Bring front- and side-view photos in the same light to each consult and ask the doctor to mark which scars are tethered.
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- The 160-Participant Acne Scar Combination Trial Published in 2026: How People With Rolling Acne Scars Can Compare Acne Scar Procedures