Is subcision by itself permanent? Can it be permanent with fat transfer?

Question

Debating about getting subcision done but a little confused considering there isn't much information about it on the internet.

Arnold Almonte, DO · Answer

Hi, I'm guessing your question is pertaining to the management of facial scarring, such as old acne scars. Subcision is a well established method of breaking up old scar in order to stimulate new collagen growth with the hope of remodeling to restore smoother skin. Alternatively, lasers have been used to achieve the same thing. A newer, more advanced method that is growing amongst plastic surgeons is facial resurfacing using J-plasma Facial Rejuvenation. This treatment results in a deep peel of the superficial epidermis, followed by tightening of the underlying dermis. Lines and wrinkles significantly improve. Similar results can be achieved for old scarring as well. Seek out a surgeon that offers this alternative and have a consultation. I wish you the best!

Jason Emer, MD · Answer

Subcision is great for atrophic scars and should be combined with fillers or lasers to get the best outcome.  Dr. Emer.

John J. Martin, Jr., MD · Answer

With subcision, the fibrous scar bands are cut to help soften and elevate a scar.  By itself, the scars may reform.  Adding laser may help.  And doing fat at the same time should help the most.  The fat will help to create a layer of tissue to keep the scar bands from reforming.  But scarring is tough, and very hard to eliminate all the scars.  Hoping for improvement!

Jeff Rapaport, MD · Answer

In my opinion, subcision does produce permanent results. When performing subcision, it is important to have some adjunct to prevent the tethers from reattaching. We routinely ask patients to take baby aspirin one week prior to the treatment. If treating acne scars this is adequate to prevent reattachment. We give the patients  a suction device to assist. I believe fat transfer to be difficult when subscising acne scars. If treating larger areas, we may add a small amount of filler. The filler can prevent reattachment and stimulate additional collagen production. Fat transfer is appropriate here. Find an acne scar expert. Ask for pictures. Hope this helps. Good luck.

Mark Berkowitz, MD · Answer

superluke77 Thak you for your question but a major part is missing.  I am assuming you are asking about subcision for Acne scars.  Although my answer will be in regard to acne scars it can be relevant to other areas as well.  If you subcise alone  more than likely the area will just collapse back upon itself.  Worse yet more scarring can occur.  Placing a filler  in the area after subcision can place a layer between the newwly formed space to help block the reattachment.  Both, fat and Bellafill would be great fillers along with subcision.  All the Best Dr B

Barry L. Eppley, MD, DMD · Answer

Subcision alone is rarely adequate to correct any skin indentation, particularly if due to a scar. The underlying space that is released need to be supported by fat grafting to prevent recurrent indentation due to scar contracture.

Curtis Perry, MD · Answer

Subcision alone is generally not permanent because the area heals back together and contracts back down. In my experience subcision combined with fat transfer gives better result than either alone.

Peter A. Aldea, MD · Answer

Subscision is the cutting under a depressed scar to allow the depression to go up and assume a flatter appearance. IF the scar does NOT reattach and pull the skin down, the repair is permanent. This is why a filler is injected after the scar division to interfere with scar reattachment. Depending on the size of the depression and location, it can be any filler. But, the filler adds more of an assurance that the scar will stay flat by interfering with the re-scarring.Peter Aldea  MDMemphis, TN

Is subcision by itself permanent? Can it be permanent with fat transfer?

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