Subcision, also known as subcutaneous incision, is a dermatological procedure that releases scar tissue formed under the skin using various techniques and instruments. 

Deep scars, such as rolling acne scars, are often accompanied by fibrous bands beneath the skin surface. The bands will pull down on the skin, creating unevenness like divots, ripples, or waves on the skin’s surface. 

Subcision will loosen these bands, allowing the scars to rise to the surface and smooth out the skin contours in the process. 

The first step is mapping the scars to analyse which scars will respond to what extent to the treatment. Subcision is a surgical procedure performed under local anaesthesia or conscious sedation, depending on the scar. Your consulting dermatologist can give you more clarity after their assessment. 

The technique and the duration of the subcision depend on the scar and the dermatologist’s skills. The variations of subcision your dermatologist might choose are:

• Point subcision – will use sharp instruments
• Field subcision – Will use a combination of sharp and blunt instruments
• Minimal Subcision – Will use soft tissue filler augmentation
• Subcision based on energy

Subcision is best suited for rolling scars that barely show any changes on the skin’s surface. These scars run deep, and fibrous bands underneath the skin create wavy divots that are visible in normal light. Deep ice pick scars and boxcar acne can also benefit from this treatment, as they also have fibrous bands that extend into the skin’s subcutaneous layer. 

Professional subcision treatment for acne scars is a surgical procedure. Like any medical procedure, the results will depend on various factors like:

• The skill set of the plastic surgeon or dermatologist
• The instruments (sharp or blunt) and the techniques used.
• The severity of the inflammation and the patient’s immune response.