Subcision With Suction for Acne Scars in a 2026 Split-Face Trial: A Source-Checked 2026 Briefing for People With Atrophic Acne Scars

A 2026 split-face trial tested subcision — a procedure that releases fibrous strands pulling depressed scars downward — with added suction for atrophic acne scars. The suction-treated side earned higher physician-rated and patient-rated improvement scores.

Atrophic scars include ice-pick, boxcar, and rolling types. The U.S. National Library of Medicine PubMed record reports both subcision alone and suction-assisted subcision improved scars significantly from baseline in that trial, according to 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.

What the 2026 trial found
How does the combination work?
What did the earlier controlled trial show?
Is added suction safe?
When does subcision alone make sense?
Frequently Asked Questions

What the 2026 trial found

Physician-rated Acne Scar Improvement Grading Scale scores were higher on the suction side, with p=.002. Patient-rated scores were also higher on the suction side, with p=.026, as listed by the American Society for Dermatologic Surgery via Dermatologic Surgery on the Dermatologic Surgery journal page.

The trial authors concluded subjective assessments favored suction-assisted subcision. That pattern suggests benefits patients and doctors can see in person, even when simple scar counts miss the change.

How does the combination work?

Atrophic acne scars sit below the surrounding skin surface. Fibrotic strands tether rolling and some boxcar scars downward.

Subcision uses a needle or cannula under the skin to cut those tethers. Suction is then applied to the surface to lift tissue and help keep the released space open during early healing.

What did the earlier controlled trial show?

An earlier randomized split-face evaluator-blinded trial gave one subcision to both sides, then 10 suction sessions to one side only. The analysis covered 28 treatment areas and 154 treatments, according to the Research Square preprint.

Dermatologist raters found no difference between sides at 1 and 4 months. Patients reported 37% improvement on the suction side versus 24% on subcision alone at 1 month.

Is added suction safe?

In the prior controlled trial, both approaches caused only transient redness and swelling. Adding suction did not raise the risk of lasting adverse effects.

That safety profile matters because suction requires repeat visits. People prone to prolonged swelling, bruising, blistering, or pigment change should discuss personal risk with a dermatologist before committing.

When does subcision alone make sense?

Modest sample size and reliance on subjective scales remain key limits. A patient who wants only durable scar reduction may reasonably choose subcision alone to avoid repeated suction sessions.

Choose to discuss added suction when visible smoothness and patient-perceived improvement are the main goal.
Choose to discuss subcision alone when the priority is fewer visits and simpler aftercare.
Ask how many suction sessions a clinic uses, spacing, cost, and how progress will be judged.
Ask what scar types dominate your cheeks, temples, or jawline, since tethered rolling scars respond most directly to release.

Frequently Asked Questions

Who is this option for?

It is for people with depressed atrophic scars, especially rolling scars with downward tethering, who can attend follow-up suction visits.

How many extra visits does suction add?

Protocols vary, and the earlier trial used 10 suction sessions on one side after a single subcision.

Will suction leave lasting damage?

In the prior controlled trial, added suction caused only short-term redness and swelling, without higher lasting harm.