Subcision (+ Filler) for Acne Scar Singapore
Subcision Acne Scars
Acne affects people of all ages and gender. It can be especially upsetting when it leaves deep and permanent acne scarring. This is where subcision treatment for scars is needed to reduce the appearance of indented and “tethered” down acne scars.
Subcision is a minor procedure that breaks fibrous brands causing the depressed scars in your skin. This treatment technique allows the scars to level with the rest of your skin’s surface and eventually heal to leave no trace of any blemish. Multiple sessions of subcision are required to achieve satisfaction results. You may need to combine subcision with laser treatments for optimal results.
Since acne and acne scars are unavoidable, you should explore and choose the right treatment for your face’s scar. Here’s what you should know about subcision for treating scars.
What is Subcision Treatment?
Subcision is an acne scar treatment that specifically treats depressed scars. The main goal of this treatment is to improve your skin’s volume. It helps improve skin’s appearance by releasing fibrotic tissues that are responsible for pulling down the skin and creates the indentation.
Pitted scars have superficial indentations because of the fibrotic strands that pull the skin downwards. Subcision helps the skin to rise back up using a small special needle that cuts the fibrotic strands. It breaks up the band that causes the depression in the skin which then releases the tension of the scar. This allows a new formation of healthier tissue.
Unlike other treatment which reduces an acne scar’s appearance through treating the skin’s surface directly, subcision minimizes the appearance of acne scarring through treating the deeper layers of the skin.
This treatment is started by cleaning the patient’s skin surface, removing any traces of dirt and make-up. A topical numbing gel is applied on the area to be treated. When the area is numb, a local anaesthetic is injected.
Subcision works its magic by breaking down and releasing underlying scar tissue fibres. Dr Boey performs this treatment by inserting a tiny, hypodermic needle into the skin. The needle will then be moved back and forth in a fanning pattern while the sharp edges of the needle cut the fibrotic scar tissues. This effectively releases the scar from the underlying tissue. At this point, a snapping sound may be heard as the fibrous bands are broken. This is the releasing action that elevates the previously depressed skin. The needle is removed circumferentially around the exit to evacuate any excess blood and to minimise haematoma formation in the area. The scar will continue to heal and stimulate more collagen production.
Apart from hypodermic sharp needles, a blunt micro-cannula can also be used for subcision. This allows us to perform subcision over larger areas of scarring with less pain, less bruising and shorter recovery time.
For even better results, temporary acne scar fillers like Rejuran S can be injected into your scar immediately after subcision. Rejuran S improves scars because of 2 powerful effects. Rejuran S acts as a buffer to minimise re-attachment of scar fibres after subcision and also stimulates collagen production. Although Rejuran S will be fully absorbed naturally by your body over several months, the collagen that has been produced is permanent and gives you long-lasting improvement in your acne scars appearance.
What Types Of Scar Are Suitable For Subcision?
Subcision is a treatment specifically used for cases in which scars are depressed or pitted.
Depressed scars are caused by fibrotic strands that pull down the skin downwards, creating the indentations. A treatment targeting the deeper layers of the acne scar is needed to get rid of it effectively.
Subcision is not recommended for people who have a history of keloid scarring or if they have a blood clotting disorder.
Subcision is suitable for the following types of scars:
Rolling Acne Scars
Subcision is most ideal for rolling scars. This scar appears to be a rolling or wave-like depression on the skin. It is highly defined and makes the skin’s surface look uneven. Rolling scars are developed when fibrous bands develop between the skin and subcutaneous tissue underneath
Ice-Pick Acne Scars
This is a deep and very narrow scar that reached the dermis. They tend to be small but have a deep hole into the skin. This may come from an infection or cystic acne which destroyed the skin tissue.
Boxcar scars are oval or round depressions with steep sides. It is wider than an ice pick scar and gives the skin a pitted appearance. This may be developed by a severe breakout which destroys collagen in the skin, creating the depressed area.
What are the Benefits of Subcision?
Most effective for pitted scars
Subcision is effective for severe, challenging scars that have depressions. These scars are considered to be the hardest to get rid of. The techniques used in subcision will ultimately help you get rid of scars with depressions.
Ability to deliver healing compounds
After subcision, healing compounds like Rejuran S can be injected into the base of your acne scar to improve the results of your acne scar treatment.
Rejuran S consists of PDRN which stimulates collagen production and acts as a buffer to minimise the reforming of acne scars.
Minimal to no downtime
After a Subcision treatment, mild bruising will occur. Swelling is also common which will only last for a few days.
Safe and minimal risks
This treatment comes with minimal side effects such as haematoma. This blood clot will only last a few days and actually help the wound from healing in place. Temporary swelling is also common which will last a short time.
How Does Subcision Work?
Subcision was first described by two New York dermatologists in 1995.
The term subcision for acne scarring means subcutaneous incisionless surgery.
Subcision treatment involves releasing fibrous scar tissues that hold down the depressed scars from the horizontal plane.
Following which, fillers help to volumise and stimulate collagen synthesis.
Lasers are also used for synergistic effect as it targets scars on a vertical axis.
Dr Boey performs subcision first to release the tethered scars before using Lasers to stimulate collagen.
Subcision Cost Singapore
There are several factors that may affect the price of Subcision:
The technology and product itself aren’t just what’s important. You should also consider the experience of the doctor when it comes to severe scars. An expert can give suitable treatment advice for you so you won’t waste your valuable time and money. Be sure to ask for before and after photos of previous patients.
Area and severity of the acne scar
Large areas and deeper scars on the face will require a more intensive treatment which may result in multiple sessions. This means it will cost more.
Specialized and customized techniques
Not all treatments are “one size fits all”. An effective skin specialist will thoroughly evaluate your condition and be sure to give you a customized plan with specific treatments that are most suitable for you.
This includes Calcium fillers, Rejuran S, Hyaluronic Acid Fillers (Juvederm), and more.
Since creams and chemical peels alone cannot effectively treat deep acne scarring, a minor non-invasive surgery procedure is needed. A subcision treatment should also be performed by a reliable and trained doctor.
Subcision is priced from $400 in Singapore.
Subcision Before and After
Subcision acne scar treatments bring promising results, and most patients are highly satisfied.
Before getting started with the treatment, the patient’s comfort is a top priority. We make sure to facilitate a pain-free experience throughout the treatment.
After a subcision procedure, patients will experience mild bruising for 7-10 days. This blood clot, or bruising, supports the skin while it heals in place. Soreness may also occur which will only last a short time of about 2-3 days. There are little to no risks in subcision, which makes it a safe acne scar treatment.
Subcision is usually performed with three to six sessions for optimal results. By the time treatments are completed, about 60% to 70% of improvement is seen.
Expect a drastically reduced appearance of your deep scars and an improved, healthier skin.
Why Choose Dr Justin Boey for Subcision?
Official Trainer for Specialised Needles and Cannulas
We have a comprehensive range of specialised needles and cannulas for subcision, including the DermaSculpt blunt cannula and Nokor needle.
Dr Justin Boey is the appointed official trainer for DermaSculpt blunt cannula in Singapore.
Fillers Enhance Results
We use fillers after subcision for immediate effect as well as long term stimulation of collagen. Filler is not used as a treatment for the scar itself but as a buffer or spacer.
Subcision itself gives permanent results while filler only lasts one to two years at maximum.
Tiny amounts of filler (0.05 mL into each scar) act as a buffer which stops the bonds from reforming.
Commonly used fillers include:
- PDRN – Rejuran,
- Hyaluronic acid fillers – Juvederm, Restylane
- Bio-stimulatory fillers – Ellanse, Radiesse.
Acne Scar Specialist
Did you know that there are more than FIVE methods to perform subcision?
Our favourite is Subcision under ANGLED LIGHTING – a more accurate subcision technique for Acne Scar Removal.
Frequently Asked Questions
Who is not suitable for Subcision?
Subcision cannot be performed in individuals with active skin infection, and in individuals who are prone to abnormal skin scarring such as hypertrophic and keloidal scars.
If you are on blood thinners medication or have a bleeding disorder this increases the risk of bleeding during and after subcision procedure.
How long does it take to recover from subcision?
Immediately after subcision treatment procedure, there will be some redness and swelling that lasts for 2-3 days.
There is minimal pain after subcision.
Bruising may appear after the treatment and will fade in 5-7 days.
*individual recovery time varies.
How many sessions of Subcision do I need?
It depends on your scar location, scar severity and skin type, generally 2-4 subcision sessions spaced about 1 month apart will give the best results.
The results of subcision are also dependent on whether additional fillers, like Rejuran or HA fillers (Juvederm/Restylane/Belotero), were used.
Is Subcision treatment painful?
Subcision is pain-free throughout the procedure. A topical numbing gel is applied on the area to be treated followed by a local anaesthetic.
After the treatment, a little swelling may occur and cause mild pain. Over-the-counter medications or ice packs can be used to relieve the pain.
Can I combine this with other treatments?
Yes. Subcision complements other treatments. It can be safely combined with other treatments for optimal results. Other treatments that can be used alongside are TCA Cross, Microneedling, Topical retinoids, and Fractional Laser Treatment.