A 2026 randomized split-face trial found that subcision with suction improved atrophic acne scars more than subcision alone. Subcision is a minimally invasive procedure that releases tethered fibers pulling depressed scars downward, while suction adds vacuum lifting to the treated side.
Sdrah Diab, Ibrahim Diab and Jamal Khaddam published the trial in Dermatologic Surgery, volume 52(10), pages 989-993, epub April 23, 2026, according to the U.S. National Library of Medicine listing. Each participant received both treatments, one on each side of the face, allowing direct comparison.
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Table of Contents
- What did the new trial test?
- How much difference did suction make?
- Why did an earlier trial disagree?
- What can you discuss before treatment?
What did the new trial test?
Subcision alone is an established treatment for atrophic, or depressed, acne scars. It uses a needle or cannula under the skin to cut fibrous bands that hold scars down.
The 2026 trial tested whether added suction prevents early redepression after that release. Prior evidence for this combination was described as limited, according to the Dermatologic Surgery issue page from Wolters Kluwer.
How much difference did suction make?
Both sides improved, so suction was an added benefit rather than a requirement for response. Physician ratings and patient ratings on the Acne Scar Improvement Grading Scale were significantly higher for the suction side. Physicians scored the suction side higher at p=.002, and patients scored it higher at p=.026, according to the U.S.
National Library of Medicine summary. That means doctors and patients both saw a visible edge, with doctors showing the stronger statistical signal. The main caveat is measurement discordance. The authors concluded subjective assessments favored suction, suggesting clinically perceptible benefits not fully captured by objective scar-counting methods.
Why did an earlier trial disagree?
An earlier U.S. randomized split-face evaluator-blinded trial gave one subcision to both sides plus 10 suction sessions to one side across 28 treatment areas. Blinded dermatologists found no difference at 1 and 4 months.
Patients in that earlier trial reported 37% versus 24% improvement favoring suction at 1 month, with p=0.04, but no significant difference at 4 months, according to the Research Square preprint record. Patients preferred combination therapy 50% versus 21% at 1 month. Together, the studies point to an early visible boost from suction that fades in some measures. Expect clearer short-term texture and satisfaction gains than lasting differences in blinded scar counts.
What can you discuss before treatment?
Suction is vacuum-assisted lifting intended to release tension from contracted scars and stimulate fibroblasts, the cells that build collagen. A reported protocol started suction on day 3 after subcision, every other day for 2 weeks, with 71.73% versus 43.75% mean improvement, according to the National Institutes of Health review in PMC. Useful questions for a consultation include: Ask how your clinic handles early redepression and follow-up timing.
- Am I a candidate for subcision based on tethered rolling or depressed scars?
- What suction schedule does the clinic use, including start day and session count?
- How will improvement be tracked, by photos, grading scales, or scar counts?
- What bruising, swelling, or downtime should I plan for after combined treatment?