Understanding subcision for deep acne scars
Rolling scars look like soft, saucer-shaped depressions that become obvious in side lighting. They are caused by fibrous bands tethering the skin to deeper tissue — a mechanical problem that creams and surface treatments cannot address.
Subcision is performed after numbing, using a needle or cannula introduced through a tiny entry point. The bands are divided under the scar, which releases the tether immediately and starts a healing response that lays down collagen in the released plane.
Bruising afterwards is normal and settles over about a week. Subcision is usually staged across sessions and combined with microneedling, MNRF or fractional laser to refine the surface.
This may suit you if
- Rolling, tethered scars that lift when the skin is stretched
- Depressed scars that have not improved with resurfacing alone
- Patients who can accommodate about a week of bruising
What happens at the clinic
- 1
Marking
Scars are marked with you sitting upright in good light, because tethering is most visible in that position.
- 2
Anaesthesia
Topical and local anaesthetic are used so the procedure is comfortable.
- 3
Release
A fine needle or cannula is passed beneath each marked scar to divide the tethering bands. Pressure and cold compresses are applied immediately afterwards.
- 4
Recovery and combination
Bruising is expected for several days. Resurfacing is added in later sessions once the area has healed.
Aftercare
- Cold compresses for the first 24 hours as advised
- Sleep with the head slightly elevated on the first night
- Avoid strenuous exercise and facial massage for a week
- Keep out of direct sun while bruising settles
Possible side effects
- Bruising, swelling and tenderness
- Temporary firmness or a small nodule at a treated site, which is manageable
- Post-inflammatory pigmentation over bruised areas
- Partial improvement requiring repeat sessions