Subcision

The term “subcision” might sound complex, but it’s essential to grasp its true meaning and implications for treating acne scars. Let’s break it down:

• EX-cise: To remove something by cutting around it.
• IN-cise: To cut into something.
• SUB-cise: To cut below something.

When it comes to acne scarring, there’s a lot of interest and misunderstanding about subcision. It’s crucial to know that not all subcision techniques are the same, and poor results are often the outcome of inadequate methods.

The most aggressive form of subcision is a facelift, where the skin is completely separated from the underlying tissues. While effective, this approach is not suitable for most acne scar patients.

Nonsurgical practitioners commonly use a method of “localized” subcision. This method involves inserting a needle into the skin near the scar and wiggling it back and forth to break some of the scar tissue. This technique offers moderate results and is best suited for treating very small areas of acne scarring.

For larger areas of acne scarring, a more aggressive form of subcision is necessary. This requires a larger area of local and a specialized “V”-shaped needle. The entry point is strategically placed in the sideburn or corner of the mouth to ensure no visible signs of the procedure. This technique allows for more effective release of the scar tissue over a broader area, making it ideal for extensive acne scarring.

However, subcision is only part of the solution. Once the scar tissue is released, the created space must be filled to prevent the skin from retracting back into the “hole.”

The Acne Scar Rewind procedure involves subcising a broad area of the face, such as the cheeks, through small incisions hidden in the hairline or corner of the mouth. Special needles are then used to cut the tethered scar tissue from below. After releasing the underlying scar, the skin is supported from below with a blend of the patient’s own fat and PRP/stem cells. This helps to “push” the skin back up, preventing it from returning to its previously depressed shape.

It’s important to distinguish this comprehensive approach from the limited subcision techniques often offered by dermatologists, which treat individual scars one at a time. For patients with severe or widespread acne scarring, these limited methods require numerous treatments and yield less significant results.

With the expertise of a skilled plastic surgeon like Dr. Richard Sadove, the Acne Scar Rewind technique allows for a more aggressive treatment, enabling most patients to achieve their desired results in a single visit.

For more information, watch our animated video on subcision to see how this transformative procedure is performed.