Subcision

EX-cise means to remove something by cutting around it. IN-cise means to cut into something. To SUB-cise is to cut below something.

There is a great deal of interest and misunderstanding of the word subcision when it comes to acne scarring. It is very important to understand that not all subcision is the same. Not all subcision is alike, but poor results seldom differ.

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

There’s a form of subcision which is usually done by nonsurgical practitioners. The “needle wiggle” technique is limited in its usefulness only for very small areas of acne scarring. A needle is passed into the exposed skin near the scar. It is wiggled back and forth in an attempt to break some of the scar beneath the acne scar. This gives usually moderate results and is limited  to only small areas of acne scar.

When it comes to larger areas of acne scar, a more aggressive form of subcision is performed. A larger area of local anesthesia is required. A larger and longer “V” shaped “undermine” specialized needle is required. The entry point is located in the “side burn” or corner of the mouth were no sign of its entry will be visible. This more aggressive subcision is performed over a wider area where many scars are located. Such treatment is more effective at releasing scar.

Subcision is only part of the treatment. After scar is released, the space created must be filled in order to prevent the skin from retracting back into the “hole”.

The Acne Scar Rewind procedure subcises a broad area of the face, like the cheeks, through a small hidden scar placed in the hairline and/or corner of the mouth where it will not be visible after healing. Once the tiny incisions are made, special needles are passed below the skin to cut the tethered scar from below.

When the underlying scar is released, the skin needs to be supported from below to smooth out the surface texture. A special blend of the patient’s own fat and PRP/Stem cells is injected into the released space, helping to “push” the skin back up.  This is required in order to prevent the upper skin from returning to its previously depressed shape. 

This type of broad subcision should not be confused with limited subcision offered by some dermatologists. Limited subcision treats individual scars, one at a time. For patients with more severe or widespread acne scarring, this would require numerous treatments and yield more limited results.

With the skill and experience of a plastic surgeon like Dr.Richard Sadove, the issue can be treated more aggressively with the Acne Scar Rewind technique and most patients achieve their desired result with a single visit.