Does Subcision Produce the Best Results?
Dr. Hazany compares acne scars to potholes in the street, emphasizing that the proper repair method does not involve leveling the entire road to match the pothole’s depth, but rather filling and raising the pothole.
This analogy extends to acne scar treatment, where subcision elevates depressed or rolling scars to align with the surrounding skin surface. Using a hypodermic needle, fibrotic strands tethering scar tissue are manually broken, targeting scar tissue across different skin layers with varying needle sizes.
Acne Scar Treatments: Subcision vs. Laser Therapy
Laser resurfacing, microneedling, and other treatments that aim to smooth and reduce the skin to match acne scarring can be compared to leveling the entire road down to the depth of a pothole. Despite this pitfall, dermatologists widely use laser treatment to enhance the appearance of acne scars and atrophic scars. While Dr. Hazany acknowledges the effectiveness of lasers in scar revision, he advocates for subcision in treating larger and smaller areas of scarring. Subcision avoids unnecessary thinning of the skin and typically achieves desired outcomes in only one treatment.
How Is Subcision Performed?
Subcision can be performed in just a few hours with the aid of a local anesthetic, tumescent anesthesia, and anti-anxiety medication to guarantee comfort. To begin, the provider will delicately insert a hypodermic needle into the skin to reach the desired depth. Then, the needle is moved laterally to sever the fibrotic tethers, thus realigning the atrophic scars with the surrounding healthy skin. This process of “controlled trauma” also stimulates collagen production, reinforcing and supporting the previously scarred areas.
The subcision procedure can be performed in several layers: superficial-layer, mid-layer, and deep-layer.
- Superficial-layer subcision: A needle is used to infiltrate the skin right below the epidermis.
- Middle-layer subcision: A blunt cannula is used to penetrate deeper into the dermis.
- Deep-layer subcision: A special metal tool is inserted into the deepest layer of the dermis to separate the toughest scars from underlying tissue.
Since middle-layer and deep-layer subcision treatment are more invasive than superficial-layer subcision, an “introducer”-needle is inserted into the skin to create a small opening for the cannula to be inserted.
Recovery Instructions
Adhering to post-procedural care instructions is crucial for a speedy recovery. Immediately following the procedure, mild soreness, skin discoloration, and blood-tinged oozing can set in and last for up to one week. To prevent infection, avoid touching the treated area(s) and keep completely dry for the initial 24 hours. After this period, you can start to use a cold and damp compress in intervals of 10-15 minutes to alleviate swelling and discomfort. Additionally after showering, apply a thin layer of Vaseline or petroleum jelly to maintain skin moisture. Normal activities can usually resume within 48 hours, but avoid picking at any scabs that form, as they are essential for scar healing. Refrain from applying makeup or other cosmetics to the treated area for at least 24 hours, and minimize sun exposure throughout the healing process. If exposure is necessary, apply sunscreen with SPF 50+ to protect the treated area.
How Much Does Subcision Cost?
The price of subcision varies on a case-by-case basis depending on your unique acne scarring profile. The cost can increase if you need more layers (superficial, middle, and/or deep) done as well as if you have multiple affected areas. However, the results of subcision are long-lasting, which eliminates the need to spend additional money on maintenance treatments. Also, subcision avoids thinning the skin, which means you will not have to invest in collagen-boosting formulas or dermal fillers either.
Currently, subcision stands as a leading procedure for patients in La Cañada Flintridge to improve the appearance of their acne scars. We invite you to contact our scar specialists for further details and to develop your tailored treatment strategy!
