Subcision with suction is not a proven stronger scar remover than subcision alone for rolling acne scars. In the 2026 split-face trial, suction added higher improvement ratings but no lasting edge on blinded scar scores, so read it as a possible visible boost rather than better clearance.
Subcision is a procedure that cuts fibrous bands tethering skin down. Rolling scars are shallow, wavy depressions, typically to 5mm, caused by those bands pulling the surface toward deeper tissue. The trial tested one subcision on both cheeks, plus suction on one randomly assigned side.
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 split-face test compare?
- Where did suction help, and where did it not?
- Why does the early preference fade?
- Should you book the extra suction visits?
What did the split-face test compare?
Each participant received one subcision treatment to both facial sides, then 10 suction sessions to one side only. Photos were taken at baseline, 1 month, and 4 months, according to the Research Square preprint by Shi and colleagues the study preprint. The design kept the comparison fair within the same person.
The registry entry describes it as a completed pilot split-face, evaluator-blinded study specifically for rolling acne scars to test added benefit, according to the ICH GCP clinical trials registry the registry entry. That structure controls for skin type, healing, and sun exposure. Any difference comes from suction, not from different people healing differently.
Where did suction help, and where did it not?
Blinded dermatologist raters found no significant difference between subcision alone and subcision-suction at 1 or 4 months on validated scar scales. That result covered 28 treatment areas and 154 treatments. Patients saw more change early. They reported 37% mean improvement with suction versus 24% without it at 1 month, but the gap closed by 4 months.
They preferred the combination 50% versus 21% at 1 month. The 2026 journal report also found both sides improved, with physician- and patient-rated improvement scores significantly higher on the suction side, according to the U.S. National Library of Medicine PubMed abstract the PubMed abstract. In plain terms, eyes noticed more improvement with suction even when scar counts did not shift.
Why does the early preference fade?
Subcision releases tethered bands and the resulting blood collection supports collagen formation. Suction adds a mechanical lift on top of that release, according to the National Institutes of Health PMC review of subcision the NIH review. Lift, swelling, and smoother light reflection can look better at week four.
Scar remodeling takes longer and depends more on the cut band and new collagen. That split explains strong early patient ratings without a lasting scale difference. The short window matters. Follow-up ended at 4 months, so durability beyond that point remains untested in this study.
Should you book the extra suction visits?
Use the headline test: better ratings are not the same as fewer scars. If your main goal is durable reduction in rolling depressions, added suction did not prove extra value at 4 months.
Ask practical questions before agreeing to 10 extra visits: Patients wanting only long-term reduction may reasonably skip the added suction sessions. Bring baseline photos in the same light and angle, then compare the same views at 1 and 4 months before buying more sessions.
- How many visits, how long, and what is the added cost?
- What result will you judge at 3 to 4 months, not week two?
- What aftercare, bruising, or downtime does suction add?
- When would your dermatologist stop suction if improvement stalls?
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