Acne scarring can range in severity from just a few scars to scarring that spans the entire face.
Dr. Yang traditionally performs subcision to reduce the appearance of depressed acne scars, or acne scars that create an uneven skin surface. The most common types of acne scars treated by Dr. Yang are rolling scars, a type of scarring that occurs due to cystic acne. Depending on the nature of a patient’s scarring, Dr. Yang may choose one technique or a combination to improve the appearance of acne scars.
Subcision for Acne Scarring Candidate
Patients with scarring due to cystic acne, acne in their youth, and any other variation of acne are typically a candidate for this procedure.
About the Procedure
Dr. Yang performs subcision for acne scarring in the office under local anesthesia. Many patients can undergo the procedure on the same date of their first consultation. After discussing the procedure with the patient, Dr. Yang applies a topical numbing gel to reduce any discomfort associated with injecting the local anesthetic. Once local anesthesia has been injected to the area being treated, Dr. Yang uses a hypodermic needle to puncture the skin and undermine the outer layer of skin, thereby releasing it from the facial tissue. Using a back and forth motion, Dr. Yang is able to break the fibrous tissues causing the scarring indentations and unevenness.
Dr. Yang may recommend injectable fillers instead of or in addition to subcision depending on the nature and severity of the scarring. Fillers are injected into the site of the acne scar to add volume to any depression caused by acne scars.
The more bruising the patient experiences, the better this procedure appears to work. When the skin becomes untethered to the underlying scar and fascia, it has a chance to heal flush with the rest of the dermal layer. Creating the blood clot underneath the scar (what we call bruising) provides support for the skin while it heals in place. Dr. Yang has found that although the response to subcision varies from patient to patient, generally if the subcised area is very small (about the size of a hole punch), the blood clot may not be large enough to prevent the untethered skin from healing back into the depression.
The procedure itself lasts typically no longer than half an hour after which the patient will ice the area either in the office or at home.