Subcision for Acne Scarring

Acne scars can be a frustrating reminder of a breakout, and often, acne scars can be even more difficult to treat than the original acne breakouts. Subcision acne scar treatment is one option for reducing scar tissue and stimulating new collagen production to improve the appearance of some types of acne scars. Subcision treatment, also referred to as subcutaneous incision-less surgery, is an in-office cosmetic procedure that is performed daily by acne scar specialist Dr. Michele Green in her NYC dermatology office. Dr. Green often combines subcision with dermal fillers to replenish volume loss to depressed scars, providing optimal cosmetic results.

Subcision is an effective treatment for depressed scars such as rolling scars and shallow boxcar scars. Subcision is not typically recommended for icepick scars or very deep boxcar scars. Acne scar subcision typically requires multiple treatment sessions to achieve desired results but can easily be combined with other acne scars treatment options, such as chemical peels, laser resurfacing, microneedling, and dermal fillers to create the most effective treatment plan for the types of acne scars a given patient has. It is important to always consult with a board-certified dermatologist for acne scar revision treatment in order to achieve the best cosmetic results, prevent unwanted side effects (like hyperpigmentation and keloid scars), and guarantee that the recommended acne scar treatments are appropriate for your skin type and the types of scars present.

Dr. Michele Green in New York City is an internationally renowned, board-certified dermatologist with over two and a half decades of experience providing some of the world’s most discerning men and women with the best skincare and minimally invasive cosmetic treatment options available, including subcision treatment for acne scars. For her dedication to her patients and expertise, Dr. Green is consistently identified as one of the best dermatologists in New York by Castle Connolly, New York Magazine, and Super Doctors. She takes a holistic approach to facial rejuvenation treatment and embraces a ‘less is more’ philosophy, customizing each treatment plan to incorporate the unique combination of specially formulated skincare products and in-office treatment options that are best suited to the specific concerns and overall aesthetic goals of each patient.

What is Subcision acne scar treatment?

Subcision, also known as subcutaneous incision-less surgery, is a minor surgery in dermatology that can be used to treat depressed acne scars. Subcision treatment is typically recommended for a type of acne scar called rolling scars. Rolling scars are caused by fibrotic strands of tissue that tether the top layers of skin to the underlying tissue. These fibrotic strands form as part of the natural wound-healing process of skin. The process is triggered by the inflammation and irritation associated with an acne lesion, which is part of what makes prompt and effective treatment of acne so important.

During a subcision procedure, a nokor needle, cannula, or number 18 or 20 gauge hypodermic needle is used to puncture the skin surface. The sharp edge of the needle is then used to break up the fibrotic strands of scar tissue that are tethering the top layers of skin to the underlying tissue. Once the tether is broken and the fibrotic bands of scar tissue are released, the skin is encouraged to produce new collagen in the treated area and heal with a smoother, more even texture. If subcision is performed with dermal fillers, the filler is then injected directly into the acne scar to replace lost volume and provide a smoother skin surface. Performing subcision in conjunction with hyaluronic acid dermal fillers provides optimal cosmetic results with essentially zero downtime. The most common side effects of subcision treatment with dermal fillers are a mild amount of swelling, bruising, and tenderness in the treated area, which resolve on their own shortly after treatment. Over several months, new collagen is continually produced, and a noticeable cosmetic improvement in the acne scars is seen.

How to perform the subcision procedure for acne scars

Only an experienced board-certified dermatologist, such as Dr. Michele Green in NYC, should perform subcision treatment for acne scars. Working with a board-certified dermatologist helps prevent unwanted potential side effects while ensuring optimal results. The subcision procedure involves inserting a cannula or needle into the skin to break apart fibrotic strands that tether acne scars to underlying tissue.

Prior to having subcision treatment for acne scars, a formal consultation with Dr. Green will take place in her private dermatology office in the Upper East Side neighborhood of New York City. During the initial consultation, Dr. Green will collect a thorough medical history, review any previous acne scar treatments, including microneedling, chemical peels, or dermal fillers, and identify your main areas of concern. Dr. Green will work with you to establish a customized acne scar treatment plan that is best suited to your skin needs, cosmetic goals, and unique situation.

Photographs of the treatment area are always taken for your medical record and used to enhance your discussion with Dr. Green, together determining which acne scar treatment option would be ideal for use to address and correct your specific concerns. Suppose subcision or subcision with dermal fillers is the best acne scar treatment option for you. In that case, the subcision procedure may be done the same day as your consultation with Dr. Green or scheduled for a later date, depending on your preferences and time allowance.

Potential side effects of acne scar treatment with subcision include a mild amount of swelling, bruising, and tenderness at or near the injection sites. In order to best prevent any bruising in the treatment area, Dr. Green recommends that one week before your scheduled treatment with subcision for acne scars, you stop taking any blood thinners and non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil, Motrin, and Aleve. She also suggests that you refrain from taking any multivitamins, herbal supplements, or fish oil during the week prior to your procedure. This step helps to avoid bruising in the treatment area after the process is complete.

On the day of your subcision treatment, a topical numbing cream should be applied to clean skin in the treated area one hour before the treatment session to ensure the subcision is as comfortable as possible for the patient. After an hour, the numbing cream will be removed, and the skin will be sterilized with alcohol to prepare for subcision. The depressed scars that are being treated are marked with a surgical pen, and an overhead light is used to visualize depressions. Dr. Green will then subcise the acne scars (and if performing with filler, inject the dermal filler into the designated treatment areas) and evaluate treatment as she completes the procedure.

An 18 or 20-gauge needle is inserted into the skin at an acute angle adjacent to the scar, with the bevel of the needle pointed upwards and parallel to the skin surface. The needle is moved back and forth through the dermis via a horizontal fanning motion to displace the scar tissue and, in turn, promote new collagen production, which will aid in the healing of the skin tissue. This regrowth is what reduces the appearance of the depressions in the skin. It helps “lift” the skin back into the correct place, resulting in an overall smoother complexion and visible reduction in acne scars.

Subcision with dermal fillers, laser treatments, chemical peels, or Microneedling

Subcision acne scar treatment can be combined with a wide variety of other dermatological treatment options in order to achieve the best results. Working with a board-certified dermatologist guarantees that your acne scar treatment plan is best suited to the types of acne scars you have. When you have your initial consultation with Dr. Green, she will examine the treatment area and determine the most effective treatment or series of acne scar treatments that will work best for you. Some of the many treatment options that can be paired with subcision acne scar revision are as follows:

• Dermal fillers – One of the treatment options that Dr. Green pairs most frequently with subcision for acne scar treatment is dermal fillers, such as Juvederm, Restylane, and Sculptra. Dermal fillers are injectable treatments designed to restore lost volume, which makes them ideal for treating atrophic acne scars (depressed scars) where a loss of collagen has led to a depression in the surface of the skin. Dermal filler treatment works by injecting the filler into the depressed scars, which instantly restores lost volume to the treated area and triggers additional collagen production, which leads to firmer, smoother skin that lasts.
• Laser Treatment such as Fraxel and eMatrix – Dr. Green may recommend laser treatment in conjunction with acne scar subcision in order to improve the tone and texture of the skin at the treatment area. There are many laser treatment options available, including the Fraxel, Vivace, eMatrix, and Clear + Brilliant lasers. At your consultation, Dr. Green will be able to determine the laser treatment that is right for you, depending on your skin type, skin tone, and the concerns to be addressed. The Fraxel laser works to eliminate the appearance of acne scars by creating a series of microscopic wounds using concentrated laser pulses. The wounds trigger the body’s natural healing process to boost new collagen production to improve the look of the acne scars over a series of 5-6 treatment sessions. The Vivace laser combines radiofrequency laser technology with microneedling to increase the production of collagen and improve the texture of the skin. The eMatrix laser and the Clear + Brilliant laser can be used on all skin types, including patients with darker skin, without the risk of hyperpigmentation. While the eMatrix uses bi-polar radiofrequency to improve skin tone and texture, the Clear + Brilliant laser acts like a mini-Fraxel laser with fractionated laser technology to boost collagen production and reduce pigmentation in the skin.
• VBeam Laser – The VBeam laser is best used specifically for broken blood vessels and to eliminate redness that is associated with acne scarring or post-inflammatory hyperpigmentation. The VBeam laser uses a pulsed dye technology, a 595-nanometer wavelength, to treat blood vessels and red pigment in the skin at the site of acne and surgical scars, reducing all visible redness. Once the blood vessels are eliminated, the appearance of the scar is improved. VBeam laser treatment can also help induce new collagen production and flatten the skin in the treated area. Several treatment sessions are needed to improve the appearance of acne scars.
• TCA Cross – Trichloroacetic acid (TCA) cross is a chemical formula that is placed directly on atrophic acne scars in order to boost the production of collagen and elastin for firmer, smoother skin. The acne scar treatment works on ice pick scars, rolling acne scars, and boxcar scars in order to elevate the skin and eliminate the appearance of depressed scars. This treatment option should not be used on patients with darker skin tones as there is a higher risk of encountering unwanted side effects such as hyperpigmentation.
• Chemical peels – Chemical peels are also very useful in improving the tone and texture of the skin alongside subcision treatment for acne scars. Many different kinds of chemical peels use a variety of acid-based ingredients to exfoliate the surface of the skin to promote skin cell turnover and the production of collagen. Chemical peels range from superficial (or light), medium depth, and deep chemical peels. To treat acne scars, Dr. Green will often opt for a superficial peel or a medium-depth peel, depending on the severity of the acne scarring.
• Microneedling – Microneedling is another acne scar treatment option that improves the texture of the skin’s surface by creating micro-injuries in the epidermis, triggering the natural wound healing process of the skin, which boosts the body’s natural collagen and elastin production. Through the use of a handheld device with surgical-grade needles, microscopic wounds are created on the surface of the skin in the treated area. Microneedling is often paired with Platelet Rich Plasma (PRP), which helps to increase the body’s production of collagen for even better results and faster healing. A series of microneedling sessions are needed for the best cosmetic results for acne scars.

Other options include IPL, Cosmelan, Mesopeel, and topical Skin Care.

Pre-Op Instructions for Subcision

• Do not tan the skin for two weeks before the procedure.
• Do not wax the skin for two weeks before Subcision.
• Refrain from using retinoids, alpha hydroxy acid creams, or other exfoliating products for three days before the procedure.
• Do not have any laser resurfacing treatments or chemical peels for two weeks before your procedure.

Post-op Instructions after Subcision

• Pressure should be applied to the treated areas immediately after the Subcision procedure with ice packs.
• Topical antibiotics should be applied twice a day to the treated area.
• Arnica can be taken orally to minimize bruising.
• Refrain from exercise, saunas, steam rooms, and intense physical activity for two weeks after the procedure.
• Return one month after the initial subcision procedure for follow-up evaluation by Dr. Green and progress photographs of the treated area.

How long does the Subcision take to heal?

Typically, there is little downtime required after a subcision treatment. In general, the skin heals within approximately one week after subcision. If the subcision treatment was combined with the use of dermal fillers and there is additional bruising, it may take up to 10 days to completely recover from the procedure. It is perfectly okay to apply makeup during this time to camouflage any visible bruising. Additionally, the herbal supplement Arnica can be taken for several days prior to (as well as for several days after) the procedure in order to help prevent and treat any bruising.

What are the potential side effects of Subcision?

• Patients can expect to see a mild amount of bruising or swelling after the treatment. However, in general, there is little downtime associated with subcision. It typically takes approximately one week for the skin to heal from Subcision treatment completely. Some patients may develop a hematoma from the procedure due to bleeding.
• Rare side effects include infection or worsening of acne lesions. Oral or topical antibiotics may be prescribed where indicated.
• The development of hypertrophic scars is another possible side effect associated with Subcision treatment. The most common areas that are susceptible to this type of keloid scarring are the periorbital, glabella, and perioral regions. The first treatment session with subcision should be performed on a limited basis to gauge the patient’s response to the procedure and prevent rare, negative side effects such as this.
• Post-inflammatory hyperpigmentation (PIH) may occur, though this side effect will resolve on its own. Strict sun avoidance should be maintained after the procedure in order to prevent worsening of post-inflammatory hyperpigmentation.

How many Subcision treatments are needed?

While just a single treatment session with subcision can still be effective for improving the appearance of acne scars, typically, multiple treatment sessions are required to achieve the best results. Most patients with moderate acne scars require between three and six sessions of subcision, and it is generally recommended that each treatment session is scheduled between four and six weeks apart. Considering the number of treatment sessions required for the best cosmetic results and the time required between each session, the acne scar treatment plan can take up to a year to complete fully. The good news is that the results that occur are permanent once the collagen in the skin has regrown. Utilizing dermal fillers in conjunction with subcision can provide improved results more quickly than subcision on its own since the dermal fillers can help replace lost volume where the acne scars are.

Can Subcision be combined with dermal fillers?

Absolutely! Dr. Green often utilizes dermal fillers when treating acne scars with subcision to provide her patients with the best long-term cosmetic results. The optimal choice of dermal filler used in conjunction with subcision is dependent upon the type or types of acne scars present. Dr. Green combines Juvederm, Restylane, or Sculptra filler products with subcision procedures to raise depressed scars effectively and fill in areas of lost volume, giving instant improvement to atrophic and rolling scars. Not only does this technique offer an immediate improvement to the appearance of the wounds, but shortly after treatment, the subcision helps boost the production of the body’s natural collagen. When subcision is done with dermal fillers, the filler is injected directly into the acne scar to replace lost volume and provide an even smoother skin surface. Dr. Green often performs subcision with Sculptra or hyaluronic acid dermal fillers to provide optimal cosmetic results with zero downtime.

Sculptra is a unique dermal filler composed of a substance called poly-L-lactic acid, which stimulates new collagen production in the treated area once injected. Over time, as new collagen is produced, the skin texture becomes smoother, reducing the appearance of depressed scars. A short series of three Sculptra treatment sessions is usually required to achieve optimal results. It takes 4 to 6 weeks to see the effect of each Sculptra treatment, and results last up to two years. Most patients engage in regular follow-up treatment sessions on an annual basis to maintain ideal results.

Subcision with hyaluronic acid dermal fillers like Juvederm and Restylane is another effective acne scar treatment option. Hyaluronic acid is a naturally occurring substance in the skin that contributes to hydration and a youthful appearance. These dermal fillers are also often used to reduce wrinkles, restore lost volume, and enhance certain facial features. Hyaluronic acid fillers provide immediate results that tend to last 6-18 months. The most common side effects include mild bruising, swelling, and tenderness at or near injection sites. This subcision technique is highly effective since you have the immediate benefit of restoring volume to these scars via the injectable filler and the long-term effect of producing new collagen for lasting rejuvenation. When you consult with Dr. Green at her private dermatology office in NYC, she will physically evaluate your skin condition and review your particular skin concerns and aesthetic goals to create a customized acne scar treatment plan best suited to you.

What are the contraindications to Subcision?

• Currently on Accutane (Isotretinoin) or patients who have taken it in the past 12 months since this will lead to poor wound healing
• Blood clotting disorder
• Active herpetic infection
• History of keloid scars
• Active bacterial infection
• History of silicone injections in the treatment area
• Recent history of laser resurfacing treatment

Combining Microneedling with PRP and Subcision for acne scar revision

One of the most popular procedures that Dr. Green performs to enhance the positive results from a subcision treatment is platelet-rich plasma (PRP) with microneedling. In studies, platelet-rich plasma has been shown to improve the appearance of atrophic scars when combined with subcision. The procedure for microneedling with platelet-rich plasma entails drawing a sample of the patient’s blood and spinning it in a centrifuge to separate the plasma from the red blood cells. The plasma is then directly applied to the skin during a microneedling treatment to maximize the benefits of the platelet-rich growth factors. These growth factors encourage wound healing and new collagen formation. The PRP is able to penetrate the skin better and absorb through the creation of micro-channels in the skin that are made by the microneedling treatment. This procedure allows the depressed scars to heal more quickly and leads to the improvement of the texture, tone, and overall appearance of your acne scars.

How much is Subcision for acne scars?

When patients ask how much Subcision costs, the answer is it depends. The price for acne scar treatment with subcision varies depending on a number of factors involved with the treatment. The experience level of the physician who is performing the procedure, the geographic location of the medical office where you are treated, and the severity of the acne scars requiring treatment will all influence the total cost of your treatment. Patients with more severe acne scars will likely require more subcision treatment sessions. Additionally, if any dermal fillers are utilized in tandem with the subcision procedure, the cost of the Juvederm, Restylane, or Sculptra products will be factored into the total treatment cost and will vary depending on how much of the dermal filler product is needed. It’s important to choose a provider with adequate knowledge, experience, and exceptional skill to perform your subcision treatment to ensure that you have outstanding cosmetic results. During your consultation with Dr. Green, it will be determined which type and what quantity of dermal fillers will best complement your subcision procedure and the total cost discussed.

Does Subcision work?

Subcision is a very effective treatment method for improving acne scars. Alam, Omura, and Kaminer published a seminal paper that demonstrated the positive impact of subcision for acne scars, highlighting the efficacy of the treatment technique, especially for rolling scars. A number of other medical journals have since published additional papers featuring the improvement of acne scars produced by subcision in conjunction with other treatments for acne scars, such as Microneedling with platelet-rich plasma and laser resurfacing treatments. A careful analysis of the type of acne scars, rolling scars, ice pick, or boxcar scars is important when it comes to determining the most appropriate treatment methods. Dr. Green will give you an honest assessment and advise you on the best combination of treatment options for your acne scars.

Can Subcision make scars worse or cause scarring?

The majority of patients do not experience any scarring after having subcision for acne scars. However, there is a potential risk that the appearance of acne scars may not improve or may even worsen after having subcision. Five percent of patients develop keloid scars from subcision treatment. This rare effect typically occurs exclusively in patients who are prone to developing keloid scars, particularly around the mouth and eye areas. If you have a history of keloids, discuss this with Dr. Green during your consultation for treating acne scars.

Is the Subcision procedure painful?

No, subcision is performed with topical or local anesthesia, making it a comfortable cosmetic procedure. When patients ask if the subcision hurts, the answer is that the procedure is mostly painless. Before patients arrive at Dr. Green’s office for the process, she will prescribe a topical numbing cream to the treatment area to reduce any potential discomfort of the treatment. The topical anesthetic will numb the area for the duration of the treatment, and as such, there will be no pain involved during the procedure itself. In the days following the procedure, patients may experience some slight bruising or swelling.

Does Subcision last forever? Is Subcision permanent for acne scars?

Subcision acne scar treatment is a permanent procedure designed to eliminate the appearance of depressed acne scars. The treatment works to induce the body’s natural wound-healing process, which in turn produces new collagen for a natural and permanent solution to acne scarring. While the long-term effects of acne scar subcision have not yet been extensively studied, several small-scale studies have demonstrated the accessibility and longevity of the treatment, including a 2010 study published by the National Institute of Health. The International Journal of Research in Medical Sciences published research in 2016 demonstrating that out of three common acne scar treatments, subcision, CO2 fractional lasers, and derma rollers, subcision was the most successful at treating acne scars.

How does subcision work?

Subcision is a minor surgical procedure performed under topical or local anesthesia that triggers the body’s natural healing process to eliminate the appearance of depressed acne scars. The procedure is performed with a small needle that is inserted into the top layer of the skin parallel to the surface. The needle is then used to destroy the fibrous strands that bind the upper layer of tissue to the lower layer, which serves to lift the scar and reverse the depressed appearance. At the same time, the breaking of the fibrous bands triggers the body to produce more collagen and elastin, which help to improve the structure and texture of the skin. Subcision for acne scars can also be combined with other treatments, such as dermal fillers, laser treatment, chemical peels, and microneedling. Subcision can also improve the appearance of cellulite and surgical scars.

Can subcision cause acne or make acne worse?

It is possible to experience a flare-up of acne after undergoing subcision for acne scars. If you are prone to acne breakouts, it may be advised to take a course of oral or topical antibiotics in anticipation of your appointment in order to prevent a flare-up. Consult with Dr. Green if you are acne-prone and interested in proceeding with subcision treatment for acne scars.

How long does it take for Subcision to work?

The results of a Subcision treatment start to be evident immediately after the procedure is complete. While there may be some initial swelling in the treatment areas, this generally resolves within 1-2 weeks after the procedure. At that time, the full results of treatment may be observed. Shortly after treatment, new collagen is generated. Collagen production continues to increase over the next few months, progressively improving the overall appearance of the acne scars. Additionally, each subsequent subcision procedure helps to contribute to new collagen production, enhancing the cosmetic results and providing a smooth, beautiful, healthy look and feel.

Combining other acne scar treatments with Subcision

Acne lesions don’t uniformly cause scars, and the majority of patients who struggle with acne scars will present with multiple types of acne scars, including rolling scars, atrophic scars, boxcar scars, and icepick scars. While subcision for acne scars can be performed as a stand-alone procedure in order to diminish the appearance of varying types of acne scars completely, most patients require a combination treatment approach.

In the discreet dermatology office of Dr. Green, located in the Upper East Side of Manhattan, she often combines subcision for acne scars with a number of other scar revision procedures. Depending on the skin type, skin tone, and the types of acne scars of the patient, energy-based devices such as the eMatrix laser, Fraxel Dual laser, VBeam laser, Picosure, and Erbium lasers may be used to improve the texture and tone of the skin after subcision. Many of these lasers are an exceptional treatment option for patients of all different skin types and skin tones, including Asian, Hispanic, and African American skin. Dr. Green aptly selects the cosmetic laser treatments that are best suited to each patient to provide the best results.

To minimize the appearance of ice pick scars, TCA Cross is considered to be the gold standard treatment. With this treatment technique, 50% to 100% trichloroacetic acid (TCA) is applied meticulously with a wooden applicator to each ice pick scar. The scars develop a frost from the TCA; then afterward, the treatment areas begin to scab over and start to heal. As a part of the natural healing process, new collagen production is induced, resulting in a smoother and firmer skin texture and an overall reduction in the appearance of the icepick scar.

The VBeam laser is the ideal treatment for resolving any facial redness and minimizing the appearance of red acne scars. The Vbeam operates on a wavelength that only targets skin cells holding onto red pigment. The pigment absorbs the energy from the laser beam and is destroyed while the surrounding skin is left untouched. Broken capillaries, areas of post-inflammatory hyperpigmentation, stretch marks, rosacea, and acne scars can all be effectively diminished by using the Vbeam treatment. Additionally, the Vbeam has a built-in Dynamic Cooling Device that works to cool the skin prior to emitting the laser pulse, making the procedure as comfortable as possible for the patient. As another great bonus, there is no downtime involved, meaning one can carry on with their normal daily activities immediately following completion of the treatment. The VBeam laser is the gold standard when it comes to removing areas of visible redness from the face, surgical scars, and acne scars. After completing between 3 and 5 treatments of the VBeam laser, the redness is noticeably reduced to reveal a complexion that is more even-toned and clear.

Texture and redness are not the only potential visible signs associated with acne scars. Many patients who suffer from acne scars tend to experience hyperpigmentation or discolored skin as a result of having an acne breakout. There are varying forms of hyperpigmented spots that may develop secondary to acne, including post-inflammatory hyperpigmentation (PIH). Spots of post-inflammatory hyperpigmentation may resolve on their own, though it can take weeks or months to diminish completely. There are, however, a number of skin care products and in-office procedures that can help to hasten the diminishment of these dark marks left behind after acne. Dr. Green often recommends a combination of specially formulated skincare products for lightening, such as hydroquinones, from her MGSKINLABS, Inc. line of products and chemical peels. Dr. Green has found that this combination of prescription skin care products and in-office chemical peels provides great results for reducing the areas of visible hyperpigmentation, ultimately evening out the discoloration and texture of the skin.

For some patients, Dr. Green may choose to use the Fraxel laser to treat areas of unwanted skin pigmentation as well as remove brown spots, sun damage, acne scars, and wrinkles. Dr. Green often refers to the Fraxel as the “Magic Eraser” for its unique ability to address a host of varying skin concerns, and she considers it to be the gold standard treatment for improving skin tone and texture. Fraxel works by creating controlled, microscopic wounds in the skin through the application of highly concentrated laser pulses. As the skin repairs these wounds, collagen production increases, new skin cells grow, and acne scars, fine lines and wrinkles, skin pigmentation, and damage from the sun begin to heal. Fraxel can be combined with other skin rejuvenating procedures and delivers phenomenal results with almost no downtime.

eMatrix is another laser resurfacing treatment that is safe and effective for patients of every skin type and skin tone. This laser treatment relies on bi-polar radiofrequency energy to create micro-injuries in the dermis while leaving the skin’s surface intact. The procedure stimulates the wound-healing process of the skin, which leads to new collagen production. The result is smoother, firmer skin. Most patients taking advantage of eMatrix as an acne scar treatment require 4-6 treatment sessions to achieve their final desired results. There is very little downtime associated with the laser treatment, and the most common side effects of eMatrix are a mild amount of facial redness and skin swelling, which resolve on their own shortly after the procedure. It is, however, very important to limit sun exposure and use proper sun protection following eMatrix, as is with any laser treatment, due to increased skin photosensitivity during the healing process.

Vivace Microneedling is one of the newest FDA-cleared cosmetic procedures that has been released. This acne scar treatment is an innovative combination of two other forms of therapy: microneedling and radio frequency (RF) energy. The combination of treatment modalities makes Vivace an excellent treatment option for improving the appearance of acne scars, fine lines and wrinkles, skin laxity, and boosting overall skin health. While radiofrequency delivers heat to the dermis, the microneedling element of Vivace is used to create micro-injuries in the epidermis for maximum new collagen production. Most patients undergo a short series of three treatment sessions, each spaced approximately four weeks apart, to obtain the best cosmetic results. Vivace is a safe and effective treatment for patients of any skin type and skin tone, and there is essentially zero downtime involved, meaning patients can schedule their treatment sessions with ease.

Subcision treatment can also be combined with dermal fillers such as Restylane, Juvederm, and Sculptra. Dr. Green loves the effect of combining subcision with dermal filler since the filler can help enhance the overall effects of the subcision procedure. The formation of acne scars tends to go hand-in-hand with lost volume and collagen in the affected area of the skin. For her patients who undergo subcision, Dr. Green often recommends utilization of a dermal filler in order to help replace lost volume in the area of the scar. By replenishing the lost volume with dermal fillers, the skin is rejuvenated, and the overall appearance of the acne scars is improved with long-lasting results. To learn more about subcision with dermal fillers, schedule a consultation with board-certified, expert cosmetic dermatologist Dr. Michele Green.

Is Subcision effective for acne scars?

Subcision is a great treatment option for certain types of atrophic acne scars. Dr. Green usually recommends combining subcision with dermal fillers to stimulate new collagen production and replenish volume loss simultaneously. While subcision is a great treatment option for rolling and boxcar scars, it typically is not recommended for icepick scars, post-inflammatory hyperpigmentation, or keloid scars. Ultimately, the acne scar treatment plan that is best suited to you will depend on the types of acne scars present. When it comes to acne scars, every individual patient will uniquely form scars; there’s no “one size fits all” rule. In order to determine which cosmetic treatment option will be most effective in the diminishment of acne scars, it’s important first to understand which variety of acne scars are present. During your acne scar treatment consultation, Dr. Green will collect a thorough medical history, review any acne scar treatments you may have already had, evaluate your acne scars, and customize a skin care and acne scar treatment program to rejuvenate your skin and improve the cosmetic appearance of your acne scars.

What is the difference between subcision and laser resurfacing?

Subcision with dermal fillers and laser resurfacing are both excellent treatment options for reducing the appearance of acne scars. They are often used as complements in the acne scar treatment plans of patients of internationally renowned, board-certified dermatologist Dr. Michele Green. Subcision entails using a cannula or needle to break apart underlying scar tissue and stimulate new collagen production. Fraxel, eMatrix, and CO2 laser are popular laser resurfacing treatment options that are essentially used to create controlled injuries to the skin in order to induce new collagen production during the natural wound healing process. Using different treatment options in conjunction, like laser resurfacing procedures and subcision with dermal fillers, allows for maximum collagen production, which produces optimal results. Most patients need to use more than one type of acne scar treatment in order to get their desired results, and a dermatologist like Dr. Michele Green in NYC can work with you to create a customized acne scar treatment plan that is catered to the types of acne scars present.

What is the best way to get rid of acne scars?

The best way to get rid of acne scars is to consult with a board-certified dermatologist, such as Dr. Michele Green in NYC. Since there are different types of acne scars, and no two individuals will develop acne scars in the same way, it is important to create a personalized acne scar treatment plan. A dermatologist has the expertise to recommend acne scar treatment options that will be safe for your skin type and skin tone while providing you with the best cosmetic results. When you consult with Dr. Green, she will work with you to create a customized treatment plan for your acne scars that incorporates the specific in-office procedures and specially formulated skincare products that are the most effective treatments for the types of acne scars present.

What happens after a subcision treatment?

Immediately upon completion of subcision treatment, ice packs are applied to the treatment area to help minimize swelling. It is common to experience side effects such as mild swelling, bruising, and tenderness in the treatment area for several days following the subcision procedure. These side effects typically resolve on their own shortly after the treatment, but patients may choose to use Arnika. This herbal supplement helps reduce bruising and accelerate the healing process. Patients should refrain from strenuous exercise for at least 48 hours following their subcision treatment session in order to prevent worsening of swelling. Patients typically undergo a short series of 3-6 subcision treatments, spaced one month apart, to attain their ideal cosmetic results.

Is there downtime with subcision treatment?

Subcision is an acne scar treatment with relatively little downtime. Most patients can resume their usual daily activities shortly after their subcision treatment. It is advised to refrain from strenuous exercise for 48 hours following subcision to limit swelling. The most common side effects of subcision include swelling, bruising, tenderness, and redness, which tend to resolve within several days of the procedure. Patients who are very susceptible to bruising are recommended to take Arnika, an oral herbal supplement, for several days before their subcision treatment. Arinka has been shown to prevent and treat bruising.

How effective is subcision for acne scars?

Subcision is very effective in treating rolling and boxcar scars, but it is not an effective treatment for keloid scars, post-inflammatory hyperpigmentation, or icepick scars. Subcision is a unique acne scar treatment in that it can release the fibrotic strands that tether scars in addition to stimulating new collagen production. This can not be achieved with other acne scar treatment options, like lasers, chemical peels, or microneedling. When subcision is combined with dermal fillers, the results are even better and develop more quickly.

Most patients require several subcision treatment sessions to attain their ideal cosmetic results, whether they have the treatment done with fillers or on its own. Part of the reason it is crucial to have subcision and other acne scar treatments with an experienced board-certified dermatologist is to limit the potential of encountering unwanted side effects while ensuring the best cosmetic results. Dr. Green in NYC is an internationally renowned board-certified dermatologist with over two and a half decades of experience providing acne and acne scar treatments to some of the world’s most discerning individuals. Dr. Green will work with you to create a personalized acne scar treatment plan that is safe and effective for your skin type, tone, and the types of scars you have.

Is subcision safe?

Subcision is a safe, simple, and effective acne scar treatment when it’s performed by an experienced board-certified dermatologist such as Dr. Green in NYC. A dermatologist has the expertise required to perform your subcision treatment while providing optimal cosmetic results safely. The risks of subcision are not very common. The most common side effects of subcision include bruising, swelling, and tenderness in the treated area. As subcision is a mildly invasive acne scar treatment, most patients have very little, if any, downtime. Very rarely, a granuloma may form in the treated area, which can be treated with a corticosteroid injection. Dr. Green has over 25 years of experience treating acne and acne scars and will work with you to develop a customized acne scar treatment plan that’s safe and effective for your skin type and the types of scars you have.

VBeam and eMatrix for Acne Scars before and after

Is subcision good for acne scars?

Yes! Subcision is an excellent acne scar treatment option, particularly for reducing the appearance of rolling and shallow boxcar scars. Subcision is even better when combined with dermal fillers such as Juvederm, Restylane, and Sculptra. Dermal fillers are an injectable treatment designed to restore lost volume, which makes them ideal for treating depressed scars. Dermal filler subcision treatment entails using the needle of the dermal filler syringe to break apart scar tissue, then injecting the filler into the depressed scars, which instantly restores lost volume to the treated area and triggers the additional new collagen production, leading to firmer, smoother skin that lasts.

How can I get started with subcision for my acne scars today?

Acne scars can be a difficult condition to treat, and many patients can feel self-conscious about their appearance. Luckily, there is a myriad of effective treatment options for acne scar revision available at the private dermatology office of Dr. Michele Green in New York City, including subcision for acne scar treatment with dermal fillers. If you are bothered by the appearance of your acne scars and want to learn more about what treatment options will provide you with the best results based on your skin type, skin tone, and the types of acne scars you have, schedule a consultation with Dr. Green today.

Dr. Green is an internationally renowned, board-certified dermatologist with over two and a half decades of experience providing her patients from around the world with the best non-invasive treatment options, including the treatment of acne scars. For her dedication to her patients and expertise, Dr. Green is consistently identified as one of the best dermatologists in NYC by Castle Connolly, New York Magazine, Super Doctors, and The New York Times. Dr. Green takes a holistic approach to treatment and embraces a ‘less is more’ philosophy, helping her patients achieve and maintain their ideal aesthetic goals to look and feel like the best version of themselves. As an expert in cosmetic dermatology with a special interest in helping her patients diminish the appearance of their acne scars, Dr. Green is your expert guide to achieving the smooth, clear, beautiful skin that lasts. Contact us online today or call 212-535-3088 to schedule a consultation with Dr. Green, learn more about her unique method of subcision for textural acne scars, and discover which acne scar treatments would be best for you.