Subcision for acne scars

Rolling acne scars look dented because fibrous bands tie the skin down to deeper tissue. A doctor slides a needle or blunt instrument under the skin and cuts these bands, letting the skin 'pop' back up. The bleeding underneath also triggers new collagen. Full-field techniques like the Taylor Liberator treat a whole cheek at once under tumescent anaesthetic.

The anaesthetic injections sting; after that you feel pressure and tugging but not sharp pain. Afterwards the area is sore and tender, like a bruise.

How much downtime: Moderate — 1–2 weeks of swelling and bruising; full-field subcision can mean marked swelling for the first few days.

Cost for that downtime: $300–$1,500 per session; full-field subcision $2,000–$5,000, 1–3 sessions; full-field subcision is often a single procedure.

Is it worth it? Our verdict (4/5): One of the most underrated scar treatments. If your scars are tethered, subcision is often the step that makes everything else work. Ask your doctor about it before paying for laser after laser.

• Lifts rolling and tethered scars that lasers alone barely change
• Results are often permanent once the bands are released
• Makes later laser resurfacing more effective

• Fix ice-pick scars (those need punch excision or TCA CROSS)
• Treat active acne
• Give a finished result alone; it's usually combined with laser

• Bruising and swelling
• Lumps under the skin (usually settle)
• Infection
• Bands re-attaching, so repeat sessions may be needed

Darker skin tones: Safe for darker skin, because it works under the surface and doesn't heat pigment.

Good fit

• Rolling or tethered acne scars that look worse in side lighting
• All skin tones

Avoid or ask a doctor first

• Active acne or infection
• Bleeding disorders or blood thinners (discuss with your doctor)
• Keloid tendency

Typical cost: $300–$1,500 per session; full-field subcision $2,000–$5,000 (USD, varies by city and provider)

Sessions: 1–3 sessions; full-field subcision is often a single procedure

• Dr Asif Hussein (London laser surgeon) — Subcision
• Dr Asif Hussein (London laser surgeon) — Acne scarring
• PubMed research: subcision acne scars

General information only, not medical advice. Consult a qualified dermatologist.