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Subcision

How does it work and how effective is it?

Treating deep acne scarring is one of the most challenging dilemmas in dermatological cosmetic surgery. Most patients with deep acne scars are also people with darker skin complexion i.e. Asian, African American, Hispanic and Middle eastern.

As a dermatologist and cosmetic surgeon I have a number of modalities at my disposal. Each procedure or device has a purpose and helps a small subset of patients with acne scarring the type, size, depth and location of the scarring often dictates the type of procedure or device used by me:

During the consultation he I often discuss all the procedures that may be beneficial to a patient, including TCA peels, Jessner Peels, Needling, Subsicion, Punch grafting, Erbium and CO2 fractional laser resurfacing, Cooltouch lasers, Diolite laser, Dermabrasion, Saline injections, Ultherpay (Ulthera) , Pelleve Radiofrequency treatments, and much much more.

In this blog I want to briefly discuss Subcision:

Subcision refers to a procedure whereby deeper bound down scars are treated with various size needles. These needles often have small blade-like ends and cut the fibrous bands that pull the skin down and cause deep puckered indents. The trick is to use the right size needle (I often use a NoKor needle with 16 to 22 gauge diameter) and to apply the needle to the right depth of the scar. The needle used too superficially or too aggressively can cause the skin to break down (slough off) and cause an even deeper scar. The Subcision needle applied at the wrong depth can also cause minimal improvement. The philosophy behind breaking these fibrous bands are as follows: The bands are severed with thin needles and the body secreted platelets, growth factors,  and causes new Collagen synthesis. This, in turn, results in improvement of the deeper scars. A few of the fibers invariable re-adhere. This results in some of the scars to reappear. 

An experienced Surgeon should also be able to combine Subcision with a deep chemical peel or CO2 resurfacing.

Please visit our Facebook page and watch our videos on Mixto laser, Subcision, and more.

https://www.facebook.com/pages/How-To-Treat-Acne-Scarring/187751721248937?ref_type=bookmark

Dr. A. David Rahimi