Definition
Subcision helps “lift” the skin off scarred tissue bed to reduce the severity of the depression. Depending on the technique used, there may be short term pain, bruising, or numbness to an area. Also, the insertion site of the needle or blade used to perform the subcision may create a scar in itself. Not all scars will resolve with subcision due to injury and thinning of the dermal layer. These scars may require subcision complemented with filler or fat grafting to improve their appearance and create a longer-lasting result. It looks so easy online and on procedural videos but it is not and skill and expertise make all the difference. This is one modality and scars must be evaluated by a trained specialist as multiple methods must target the patient’s needs. I can evaluate your scars and give you an acne scar plan to address your concerns and individual issues, check out the scar consulting page.
Considerations
So you know you need some subcision, perhaps you are scheduled to have it done, or you had some complications in the past. It is a relatively safe procedure with a long track record of data and outcomes.
- Medical History
- Underlying Conditions
- Ability to Heal
- Type of scars
- Scar Depth
- Prior Procedures
- Prior Complications
- Pharmaceuticals
- Are you taking blood thinners, supplements, or foods that do this
- Do you drink wine or spirits
- Are you a smoker
- Do you exercise often or do sports
- Do you have active acne on your skin or other bacterial skin infections
- Was an implant or another filler placed in that area (before)
- Poor Dr’s Skill or the tool the Dr used is incorrect (not all subcision is the same)
Side Effects
- Bruising
- Pain
- Hyperpigmentation and Discoloration
- Hematomas
- Re-attaching scars
- Phobia
- Unreal expectations
Some patients do not know the drugs they are taking (pharmaceuticals) or the side effects as a result. These prescriptions or even over the counter drugs can lead to issues when surgery is done. Tell your provider everything you take including supplements.
Haematomas (blood collection) is a common side effect with some patients.
Ethnic Patients should expect hyperpigmentation for up to a year is part of the treatment process or they should not undertake scar treatment – this is the trade off.
Keloid scars or those with a history of hypertrophic scarring should avoid this procedure as it can lead to more scarring. Also those who have autoimmune or rarer conditions where they instantly scar could be dealing with more issues.
Re-attaching scars because the Dr just did subcision with no other methods to prevent re-attachment
Fear or Phobia of Needles or Fear of what occurs during this procedure. Tell your Dr if you have a issue with this they may offer a few solutions
Unreal expectations of perfection after one treatment are one of the biggest issues with subcision.
Rare Side Effects
- Nerve Damage
- Parotiod duct(s) damage
- Retaining ligament(s) damage, premature aging
- Bacterial / Viral Infections
- Blindness
- Blood Condition & Clots
- Fat Loss
- More Scarring
- Healing for months
- Not enough healing time 3 to 6 to a year
Who is Not Eligible for the Treatment?
The treatment is not recommended for everybody. For example, people who have a case of hypertrophic or keloid scars will not be cured by this treatment. Keloid scars form when too many scars overlap and form a protruding bump on the skin. It is also not recommended for people who have disorders related to blood clotting or have been exposed to viral infection in recent times. Anyone with healing issues, health conditions, and autoimmune conditions should consult with an expert in this field, this may not be the right treatment for their condition.
Prevention
- Find an Acne Scar Expert who does this often
- Cold Compress (ice)
- Avoid Sun Exposure
- Massage
- Arnica Montana (Supplement)
- No drinking for a few days until you heal
- Raise your head when you sleep
- Lay off the actives and harsh procedures, simple sensitive skincare
I think fear and phobia about the procedure can lead to many not realizing the above are rare and unless more serious side effects occur, many of these are a normal part of treating acne scars. ROI or Risk-benefit – subcision is definitely worth it for the patient. I find consulting with a patient and alleviating their fear, awsering their questions, and educatin them during our 1-on-1 time leads to a smooth procedure.
