If you’ve been dealing with acne scars, you’ve probably come across subcision, often praised as a game-changing treatment for stubborn acne scars. Many swear by it, claiming it’s one of the most effective solutions available today. But is it really the miracle treatment it’s made out to be—or are there hidden downsides you need to consider?
Let’s dive in and explore everything you should know before considering subcision.
What Is Subcision?
Subcision is a dermatological procedure designed specifically to treat depressed acne scars. For a detailed explanation of the scar types, refer to our guide on Types of Acne Scars. Subcision works by breaking up scar tissue underneath the skin, allowing the skin to lift and become smoother. Essentially, it releases the skin from the deeper layers of scar tissue, enabling collagen production and new tissue formation.
How Does Subcision Work?
Imagine your acne scars as tiny anchors pulling your skin downward. Subcision uses a needle or specialized tool to cut these anchors beneath your skin’s surface, freeing your skin to bounce back and smooth itself out. The injury from the procedure also stimulates your body’s natural healing, leading to increased collagen production and long-term improvement.
Instruments Used in Subcision
Dermatologists choose tools based on your scar type, severity, and skin condition:
- Needles (18- to 20-gauge or Nokor Needles): Perfect for individual scars or less extensive scarring.
- Cannulas (Blunt-tipped, Flexible Tubes): Ideal if you have widespread scarring, as they can treat multiple scars with fewer entry points.
- Taylor Liberator: A specialized instrument offering more precise treatment, especially helpful for deeper, tethered scars.
- Blunt-Blade Instruments and Surgical Wires: Less commonly used but effective for specific scar types and locations.
Different Subcision Techniques
Subcision isn’t a one-size-fits-all treatment. Dermatologists adapt their approach depending on the scars:
- Superficial-layer subcision: Targets shallow scars, using fine needles just below the epidermis.
- Middle-layer subcision: Penetrates deeper into the dermis, usually with a cannula, ideal for deeper rolling scars.
- Cannula subcision: Specifically for widespread areas, allowing fewer entry points and reduced recovery time.
Potential Side Effects & Risks
Let’s get real for a moment—subcision is effective, but it’s not without potential drawbacks. Common side effects include:
- Bruising & Swelling: Almost everyone experiences mild to moderate swelling or bruising, typically fading in a few days to weeks.
- Numbness & Tingling: Some people, including myself, have experienced lingering numbness or tingling. In fact, after my Taylor Liberator subcision, I’m noticing numbness in the treated area even 1.5 years later.
- Pain & Tenderness: Usually mild and manageable, though some sensitivity might persist temporarily.
- Skin Sagging or Irregularities: While uncommon, overly aggressive subcision or improper technique can sometimes lead to slight sagging or uneven skin texture.
Always choose a skilled dermatologist or surgeon experienced in subcision to minimize these risks.
Is Subcision Painful?
The procedure is typically done with local anesthesia, making it relatively comfortable. However, you might feel some pressure or minor discomfort during the process. Post-treatment soreness can be managed easily with over-the-counter pain medication.
How Many Sessions Do You Need?
Typically, dermatologists recommend 2-4 sessions, spaced about 4-8 weeks apart. But if subcision works by cutting the scars free, why can’t one session be enough?
Here’s the reality: During the healing process after your first session, scar tissue can partially reattach or form new tethers. Additional sessions are necessary to fully release these attachments, lifting and smoothing your scars over time.
Combining Subcision with Other Treatments
Dermatologists frequently combine subcision with microneedling, lasers, or fillers for even more noticeable improvement. Combination therapies often provide the best outcomes, addressing both surface-level and deeper scars.
FAQ: Your Subcision Questions Answered
Can subcision completely remove my acne scars?
It can significantly improve them, but complete removal depends on the depth and severity of your scars.
Is the improvement from subcision permanent?
Yes, improvements are usually permanent since subcision physically alters scar tissue beneath your skin.
How long is the recovery time?
Typically, swelling and bruising resolve within 1-2 weeks, though mild residual effects can last much longer.
Does subcision improve all types of acne scars?
Subcision primarily treats depressed scars, including rolling and boxcar scars. Ice pick scars typically require additional treatments, such as chemical peels or microneedling.
