I Am a Darker Skinned Black Male with Facial Scars, Is Subcision an Option for Me? (photo)

Is subcision an option for me? I have heard that fraxel laser resurfacing is also an option...

Doctor Answers 3

Subcison and Medical Microneedling Work Well for Many Scars

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Of course, there is no substitute for seeing the scar up front and personal. In general, however, scars similar to the one shown in the photograph may respond well to a combination of therapies.

Subcision is very useful for freeing up the overlying tissue from the thick underlying scar tissue, allowing the surface to "float" upwards and for new, healthier collagen to fill in underneath and raise up the depressed area. If after a series of subcisions (usually between two to four sessions spaced at six week intervals), the base of the scar is not sufficiently raised, a small amount of filler may be added. In my experience, fillers work best for scars folliowing subcision, since the tissue underneath is looser (less bound down) and can more easily respond to the lift of the filler.

Since the surface of a scar is usually discolored, as well (typically ivory white or off-white in mature scars, and occasionally crinkly), an additional technique devoted to improving the surface characteristics may also be needed. For this purpose, I prefer medical microneedling (dermarolling), which may also entail two to four sessions with a six week gap between them. The fine microneedles used in this technique break up the surface tissue and allow the new tissue that forms in response to better blend  with the surrounding normal skin in both color and consistency. 

Finally, if there is concern that muscular activity may be contributing to the spread of the scar, tiny drops of Botox, Dysport or Xeomin may be injected very superficially in around the treatment area to diminish this and improve healing and the ultimate cosmetic result.

New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Subcision for facial scar

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  I think that you would be pleased with the results from having a filler injected below the scar.  Personally, I like Silikon 1000 for this problem.  This could be combined with a resurfacing procedure such as a chemical peel or a laser.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews


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The picture here does not look like the kind of scar tha I use subcision for. This looks like a "spread scar" that is often seen in scars where muscles are very active. Good luck to you.

Beverly Johnson, MD
Silver Spring Dermatologic Surgeon

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