A 2026 split-face trial in 27 patients found suction added to subcision improved acne scar scores, but the small sample limits firm conclusions for people with rolling scars. Subcision is a procedure that releases fibrous bands tethering depressed scars, and suction in this trial meant added vacuum sessions to keep the released tissue lifted. Both sides of the face received cannula subcision for direct comparison, according to the U.S.
National Library of Medicine (PubMed) in the Dermatologic Surgery trial record. That design tests added suction, not subcision itself. Rolling scars matter most here because they are broad, tethered depressions.
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 2026 trial actually tested
- How much did added suction help
- Why 27 patients is still thin evidence
- What this means if you have rolling scars
What the 2026 trial actually tested
Each patient had bilateral atrophic acne scars and received subcision on both facial sides. One randomly assigned side then received 10 suction sessions over 2 weeks, while the opposite side received sham pressure as control.
Patient blinding plus treatment on both sides reduces bias from individual healing differences. Both sides still improved, which points to subcision as the main driver of change.
How much did added suction help
Physician-rated and patient-rated Acne Scar Improvement Grading Scale scores were significantly higher on the suction-treated side, with p=.002 and p=.026 respectively, according to the U.S. National Library of Medicine (PubMed) in the Dermatologic Surgery trial record.
Higher scores mean greater visible improvement. Both subcision alone and suction-assisted subcision significantly improved atrophic scars. The practical reading is added benefit from suction, not suction working instead of subcision.
Why 27 patients is still thin evidence
Twenty-seven patients is a small base for lasting treatment advice. Small trials can show a real short-term signal yet leave uncertainty about size of benefit, durability, side effects, and who responds best.
An earlier split-face evaluator-blinded trial showed the same fragility. Dermatologist ratings found no difference at 1 and 4 months, according to the Research Square preprint in the February 2024 preprint record. Patients reported 37% improvement with suction versus 24% without at 1 month, but no significant difference at 4 months.
What this means if you have rolling scars
Subcision works best for rolling and tethered depressed scars and is not optimal for deep boxcar or icepick scars, according to the Journal of Clinical and Aesthetic Dermatology in the August 2019 acne scar review. People with mainly rolling scars are therefore the most relevant candidates for this approach.
The earlier trial authors listed modest sample size as a key limitation, noting the split-face design doubled treatment areas but still left only 28 treatment areas. Patients seeking only lasting scar reduction may reasonably choose subcision alone to avoid 10 suction visits, while those valuing early visible improvement may accept added suction.
- Choose subcision alone if your priority is lasting reduction with fewer visits.
- Consider added suction if early visible improvement matters enough to attend 10 sessions in 2 weeks.
- Ask whether your scars are mainly rolling and tethered, mixed with boxcar scars, or mainly icepick scars.
- Ask how your clinic defines improvement, when results are judged, and what follow-up is planned.
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