What is Subcision?
Subcision is a treatment used on some types of scars, wrinkles and cellulite dimples to help smooth the skin. It minor surgical procedure and is sometime called ‘subcutaneous incisional surgery’.
Subcision involved cutting the fibrous tissue that hold the skin down using a special hypodermic needle that is inserted through a small puncture in the skin surface.
The sharp edge of the needle is used to break fibrotic strands that are holding the scar to the underlying tissue.
By cutting the fibrotic strands there is a cosmetic improvement in the skin’s appearance which over time will continue as new collagen forms as the wound heals.
Who is it suitable for?
Subcision can be used to treatment:
- Scars due to acne (except deep icepick scars), trauma, surgery or chicken pox
- Depressed skin grafts
- Certain types of wrinkles
- Cellulite dimples
Who can’t have subcision treatments?
Subcision may not be suitable in the following circumstances:
- People who are prone to hypertrophic or keloid scars
- People who are taking or have taken oral retinoid treatments (vitamin A) within the previous 12 months. Current or recent
- People with blood clotting or bleeding disorders (coagulopathy)
- People with active bacterial or viral infections
How is subcision done?
Subcision is performed using a local anaestehtic to number the area. First the areas is cleaned and the sites to be injected are outlined using a marker.
Once the area is numbed a small puncture is made and the sharp edge of the needle is used to cut the fibrous tissue that tethers the scar, wrinkle or dimpled surface. (You may hear a snapping sound.)
Pressure is applied afterwards to reduce the risk or bruising.
Aftercare and downtime
Straight after the treatment pressure and ice are may be applied to reduce swelling and bruising.
After 24 hours you may use make up make-up may be applied to camouflage any bruising if it occurs.
Some doctors may recommend anti-inflammatory medication.
How many treatments are required?
You may need more than one treatment for a particular scar. This is because people vary in their ability to form collagen – ironically scar tissue – which helps smooth the depression out over time.
The number of subcisions required to correct a depression will depend on the type, location, severity of depression, and intensity of treatment.
In most cases, for moderate scarring three to six visits may be needed.
They should be done with at least one month between them.
What are the risks?
The risks and complications of subcision include:
- Pain/tenderness of treated sites
- Worse scarring – such as hypertrophic scars or keloid scars
- Temporary post-inflammatory hyperpigmentation (wearing sunscreen or avoiding sun exposure is advised)
- Injury to nerve or blood vessel.
Is it worth it?
If done by a well trained practitioner the risks are low and in the right patients the results can be excellent.