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What is Subscision?
Subcision also called “subcutaneous incisionless surgery” is a minor procedure in which a needle with a blade is inserted into the skin to cut the scarring attachments that cause the surface of the skin to dimple.
How is Subscision performed?
A special hypodermic needle is inserted through a puncture in the skin surface (hence, “incisionless” surgery), and its sharp edges manoeuvred under the scar to make subcuticular cuts or “-cisions”. The principle of this procedure is to break the fibrotic strands, which tether the scar to the underlying subcutaneous tissue. The release of the fibrotic strands and new collagen deposition caused by wound healing leads to cosmetic improvement of the scar. Subcision is safely performed in the outpatient setting and is usually well tolerated with no downtime.
In what situations do we do this procedure?
The decision to perform subcision will depend on the type, location, severity of scarring, patient preference and expectations. In some cases, subcision is used in conjunction with other treatments to produce appreciable results.
Subcision may be used for the treatment of:
- Depressed scars (due to acne/pimples*, trauma, surgery , chickenpox)
- Depressed skin grafts
The acne scars that benefit the most from this treatment are the rolling scars and to a lesser extent the boxcar scars.
Subcision may not be suitable in the following circumstances:
- Patients with a history of hypertrophic or keloid scars.
- Current or recent (within 6 months) use of systemic oral retinoids e.g. Isotretinoin(Roaccutane).
- Bleeding or blood clotting disorders (coagulopathy).
- Active bacterialor viral
How many treatments are required?
Individuals vary in their ability to form collagen. The number of subcision treatment sessions required to correct a depression will depend on the type, location, severity of depression, and intensity of treatment. Typically, three to six treatments at 4 weekly intervals is generally recommended for the majority of cases of moderate scarring.
How do we prepare for and what do we expect during this procedure?
Just like every procedure that has the potential to cause inflammation, to reduce the chances of post procedure darkening especially in skin of colour, we commence the use of sun protection and hypopigmenting creams 2 weeks prior. We cease intake of ginger, gingko biloba, garlic, ginseng, NSAIDS like ibuprofen and aspirin 2 weeks before procedure to reduce chances of bruising.
During the procedure we use both topical and intralesional anaesthetics to minimize pain, making it as comfortable for the patient as possible.
Are there risks and complication with this procedure?
Subcision has very minimal side effects. After the procedure, you may experience soreness at the treatment site. There may be a hematoma formation (blood collection under the skin) if a vessel is nicked, but this is similar to bruising and may simply take a little longer to resolve. The risk of infection, post inflammatory hyperpigmentation, injury to a nerve and hypertrophic scarring is minimal, but should be noted as well.
Subscision done with good improvement in a patient with post acne scarring.
How much does this treatment cost?
Cost depends on indication and size of area to be treated. Please download our comprehensive pricelist on the “about us” page of this website.