Subcision dermatology treatment option that's primarily used to release depressed scars (aka atrophic scars) caused by fibrous tissue that pulls down on the skin's surface, creating an indentation with sloping edges.
Also known as subcutaneous incisionless surgery, this minimally invasive procedure can be especially effective in the treatment of acne scars. According to a 2023 review, “subcision has been shown to improve all three atrophic acne scar types,” including:
- wide, shallow rolling scars
- boxcar scars with more clearly defined edges
- deep, narrow icepick scars
Other studies have found subcision to be more effective for rolling scars than other atrophic scars.
Research shows the technique is safe and provides significant long-term improvement for some patients with acne scars, vaccination scars, chickenpox scars, surgical scars, and those caused by skin infections.
While it's mainly used as a scar treatment, subcision can also reduce the appearance of cellulite. It's recommended for cellulite dimples that can be seen when you're sitting or standing, and studies show that the procedure can provide significant improvement for the appearance of cellulite, with a low risk of side effects. The FDA-cleared cellulite treatment Avéli is a form of subcision.
Subcision works by using a needle, cannula, surgical wire, or tiny blade to sever a fibrous band that's tethering the top layer of skin to the lower dermal layer. Once the tether is broken, the fibrotic strands of scar tissue are released from the dermis, and the depression lifts. As it heals, the skin produces new collagen, leading to a smoother, more even texture over time.
To get maximum skin-smoothing results for pockmarks (and lessen the number of treatment sessions), scar subcision is often combined with additional collagen-building treatments, like microneedling, radiofrequency microneedling, platelet-rich plasma therapy (PRP), chemical peels (such as TCA Cross), and fractional laser treatments.
For very deep scars, subcision treatment is sometimes combined with a hyaluronic acid-based dermal filler or fat injections. This promotes new collagen production, helps smooth the depression, and makes it less likely that a new tether will form.Â
