Objective scar counts showed no extra gain from suction, while patients and doctors rated the suction side higher. The 2026 split-face trial tested subcision alone against subcision plus suction for bilateral atrophic scars. Subcision is a minor procedure where a doctor passes a blunt cannula under the skin to release fibrous tethers that pull scars downward. Rolling scars are wide, shallow, wavy depressions often held down by those tethers, so release can make skin look smoother.
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 the trial tested
- Why objective and subjective scores diverged
- What this means for rolling scars
- Is added suction worth the extra visits?
What the trial tested
Twenty-seven people with scars on both cheeks received cannula subcision on both sides. One randomly chosen side then received 10 suction sessions over 2 weeks, while the other side received sham pressure, according to the NLM eFetch abstract the NLM methods summary. Doctors tracked scars at baseline, 1 month, and 4 months. They used Goodman and Baron Qualitative Grade, Modified Quantitative Global Scarring Grade, total scar counts, and the Acne Scar Improvement Grading Scale.
The design was patient-blinded and split-face, so each person served as their own comparison. The paper by Diab et al. from Latakia University appeared in Dermatologic Surgery, Vol. 52 Issue 10 pp. 989-993.
Why objective and subjective scores diverged
Both sides improved significantly over time on qualitative and quantitative grades. Scar counts also fell, with p less than .05, but objective scores did not differ between sides, according to the NLM eFetch results the NLM results summary. Perceived improvement told a different story.
Physician-rated improvement favored suction with p equals .002. Patient-rated improvement also favored suction with p equals .026. The authors concluded both approaches improved atrophic scars, with subjective assessments favoring suction. That pattern suggests a visible smoothness, brightness, or texture change that scar counting misses.
What this means for rolling scars
The trial enrolled bilateral atrophic scars generally, not rolling scars only. It followed 27 patients for 4 months in a split-face design, as described in the U.S. National Library of Medicine PubMed record.
Rolling scars fit the tether model best, so they are the most plausible beneficiaries of release plus suction. Ice-pick and deep boxcar scars depend more on surface loss and sharp walls, which suction does not refill. Expect the likely result to be smoother movement and light reflection rather than fewer counted scars. Photos in identical lighting, before treatment and at 4 months, can show that change better than a mirror memory.
Is added suction worth the extra visits?
Ten sessions in 2 weeks is a real burden in time, travel, and cost. Since objective counts stayed equal, decide based on how much you value a modest visible boost. Ask your dermatologist focused questions before committing: Bring baseline photos and ask for the same angles and lighting at 1 and 4 months to judge any smoother appearance for yourself.
- Are my main scars tethered rolling scars that move when the skin is stretched?
- How many suction visits do you use, and what does the full course cost?
- How will we judge success: photos, texture ratings, or scar counts?
You Might Also Like
- Objective vs Patient-Rated Results in the 2026 Subcision Trial: Who Was Studied and Who Was Not for People With Rolling Acne Scars
- Subcision With Suction for Acne Scars in a 2026 Split-Face Trial: A Source-Checked 2026 Briefing for People With Rolling Acne Scars
- Calcium Hydroxylapatite With CO2 Laser for Acne Scars in 2026: A Source-Checked 2026 Briefing for People With Atrophic Acne Scars