Acne scars: Is punch excision and subcision the same thing? (photos)

Question

i have a deep pitted acne scar on nose and cheek that i want removed

Jason Emer, MD · Answer

Subcision involves releasing tethers under the skin, while punch excision involves removal of damaged tissue. For pitted scars, a combination approach is needed with lasers, microneedling/prp, TCA cross, punch excision and fillers. I recommend getting a formal evaluation with an acne scarring expert. Best, Dr. Emer

Jeff Rapaport, MD · Answer

Subcision is a procedure where an instrument is placed underneath the skin, after it is anesthesized,to release the tethers and stimulate collagen to lift the scar. Excision uses a scalpel or punch to remove the tissue down to the fat and close it with a suture or let it heal. Punch excisions are extremely difficult to execute on the nose. It is not very forgiving. We combine subcision with infini, laser and PRP to improve results. Find a scar expert.

Michele S. Green, MD · Answer

There is a big difference between subcision and punch excision.  A punch excision is a surgical procedure which "punches" a whole around the scar and sutures it and removes the scar.  Subcision works by mechanically trying to untether the scar tissue under the scar.  I recommend the subcision and injection of a cosmetic filler to relieve the scar.  An excision would be very tricky in this area. I would also combine this with microneedling and PRP and eMatrix or Fraxel.  Please consult an expert in acne scar treatments for the best cosmetic results.  Best, Dr. Green

Davin Lim, MBBS, FACD - Account Suspended · Answer

Big difference between these procedures, go to the acne scars area of the site below for an in depth explanation. Essentially punch is for deep ice pick scars, subcision is for anchored and tethered scars that are bound down. Two very different but useful skills to have to revise different types of acne scars. Dr Davin Lim. Brisbane. Australia.

Acne scars: Is punch excision and subcision the same thing? (photos)

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Acne scars: Is punch excision and subcision the same thing? (photos)

Answers (4)

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