Subcision done 1 week ago. Swelling went down by 80% but remaining 20% swelling is there without improvement. Is it normal?

Question

after subscision i can see the change in scars but 20-30% of the swelling is still there and it is not coming down at the end of 7th day. while touching feels like something stuck in there. Is it normal and will come down eventually and its my mind suspicion or there is something wrong??

Mitchell Chasin, MD · Answer

Subcision is using a needle or other instrument to break up the scar tissue below. It can be gentle (for wrinkle adhesions) or quite aggressive (Deep scarring, such as pitted acne scars). I think you are right on track for recovery from subcision with acne scars, but if you feel concerned, reach out to your treating physician. Often, you can send a picture by text or email to have the doctor review. I find this to a really practical way to handle anxiety while patients are recovering, especially when there's that very normal fear that your recovery isn't going well.
Try not to poke or pick at your treated areas. You want to be gentle and allow your body to heal these areas. What you are likely feeling is hardy or lumpy - that's normal swelling. Again, I would not be too alarmed, but I would reach out to your doctor.
If your doctor is unreachable, schedule an appointment with a dermatologist or cosmetic provider who typically performs subcision (this is not that typical of a service for a plastic surgeon, so be sure to ask the front desk about the doctor's experience while scheduling).
I hope this helps! I know how worrisome it is when it's your face that's doing the healing, but try to relax and know that 7 days of swelling is completely normal for this treatment.

Davin Lim, MBBS, FACD - Account Suspended · Answer

I tell all my patients to expect 20% improvement with each treatment. Swelling is universal, only if one takes sequential photos can you see an OBJECTIVE measurement, its never about how you perceive things subjectively but what one sees objectively with scientific clinical follow ups.Subcsion was first reported in 1995. Since then this technique has taken many pathways. Most dermatologist and plastics still perform the old method- using sideways motion to break scars down. In the original papers this took 6-10 sessions using a needle. This still can be effective, but its OUTDATED. Since then other methods have evolved including-

The use of other size needles
The use of NOKOR or cutting needles
The use of cannula techniques

Of all these techniques, cannula stands out. The most recent paper this year shows that it has the best rate of scar breakdown with much less side effects than with NOKOR. Namely less bruising and ‘lumps’ from bleeding.

The results of subcision is extremely variable and will depend on the technique and experience of your Plastics or Dermatologist. Ensure they can perform all techniques competently. This is especially important with dermal fillers (or fat transfer). If one subcises a depressed scar and find it has NOT got significant tethering, a filler is needed. In this situation filler or fat is needed to elevate the scar. Subcision is my preferred method for scar revision, as I can feel how many scars I am breaking with my 3 level cannula technique. This is now considered the Gold Standard in subcsion as reviewed by peer papers. All other modalities including lasers, energy devices and peels are considered ‘instruments’ in the way I practice acne scar revision. Remember treat the scar type with a method, and you will achieve the desired outcomes. Subcsion releases and remodels acne scarring from underneath. Needless to say this just a method, the results you will achieve is 90% dependent on the skill sets of your Plastic surgeon or Dermatologist.

All the best, Dr Davin Lim

Acne Scar Specialist. Brisbane. Australia.

Subcision done 1 week ago. Swelling went down by 80% but remaining 20% swelling is there without improvement. Is it normal?

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Subcision done 1 week ago. Swelling went down by 80% but remaining 20% swelling is there without improvement. Is it normal?

Answers (2)

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Everything you need to know about Subcision

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