How effective is subcision without fillers?

Yes, Subcision is one of the most effective and best Acne Scar treatments, especially if you have deep pitted scars.

Subcision without fillers is definitely effective.

In certain types of deep atrophic acne scars that are tethered down to underlying muscle, Subcision can be more effective than Lasers (Fractional CO2/Erbium/INFINI).

How does subcision work?

The subcision acne scar procedure is more than just the mechanical release of the strands of scar tissue. Multiple biological processes are thought to occur to bring about acne scar improvement.

The mechanical action of the needle and release of the scar tissue creates a pocket beneath the skin. Blood vessels which are disrupted during the process, allows blood to accumulate into the treated area. The blood is useful to prevent short-term reattachment of the scars.

Overtime the healing phase leads to a reorganisation of blood and growth factors are released. This creates an environment for connective tissue and collagen regeneration and further reorganisation.

In addition, the healing phase that follows subcision stimulates collagen growth, repair and improvement of the scar appearance over time.

Subcision + fillers - gives even better acne removal results

I usually combine subcision with bio-stimulatory / collagen boosting fillers for best results.

This is because studies have shown that there is 20% chance that the fibrous scar tissue might "re-form" during the recovery process after subcision. Fillers help to decrease this risk.

Scar tissues "re-forming" is also another reason why more than 1 session of subcision might be needed for good acne scar removal results.

Please speak to your acne scar doctor for a detailed scar assessment and treatment plan.

Hope that this helps!

Warmest regards,

Dr Justin Boey

If you have described it as deep pitted scars, I would suggest that you speak to your doctor first. It is my experience that many patients have pre-formed notions of the correct treatments for their type of scars.. which usually isn't that correct.

I would probably consider TCA Cross for the deep pitted scars instead. Any photos would be useful!

But that said, pertaining to your question, I echo Dr Boey's idea that subcision with fillers improves the overall appearance by reducing re-attachment rates AND the biostimulatory effects would help plump up the atrophic scarred areas.

Generally my patients have been satisfied with their subcision results with the use of fillers.

So hope it works for you too.

Winston