SUBCISION & FILLING - ACNE SCAR TREATMENT
Subcision is a surgical procedure that is performed in local anesthesia.
The treatment is effective for lifting tethered rolling scars, which may form after deep acne.
Rolling scars are often tied or anchored in the subcutaneous tissue with threads of scar tissue like branches of a tree. If these threads are not cut (subcised), one will never be able to achieve a satisfactory result with other treatment modalities like lasers, RF, micro-needling or peels.
Dr. Emil Henningsen, Board Certified Dermatologist introduced this treatment in Denmark in 2014.
To date, Emil Henningsen har subcised more than 1,000 patients with this tethered acne scars. According to acne.org and other independent sources, he is regarded as one of the most skilled specialists in this treatment.
Learn about Subcision & Filling acne scar treatment
How is subcision performed?
We start by analyzing your skin to map the scars that are suitable for subcision.
The skin is cleaned, disinfected and numbed with local anesthesia using a thin needle. Anesthesia is uncomfortable, but subcision is usually a painless procedure.
Most tethered scars are released with Cannula, whereas severely tethered scars may be released with Nokor needle.
Cutting subcutaneous scar tissue immediately raises the bottom of the scars.
After subcision, the skin is compressed and cooled to reduce potential bruising.
What are the realistic results of subcision?
When performed correctly, results of subcision show gradually as a permanent and significant improvement of tethered scars. It may be advised to repeat subcision, as each procedure induces even more collagen and skin remodelling. Some of our patients return every two years (!) for subcision, as their skin heals very slowly and scars continue to improve after one year.
Some scars are not only depressed due to tethers, but also due to atrophy (loss of collagen, fat and volume). In these cases, subcision may be combined with a filler injected under each scar.
We use different brands of fillers (Restylane, Belotero, Juvederm etc). Hyaluronic acid fillers (HA) are injected under each scar individually immediately after subcision. The filler works as a buffer to prevent reformation of scar bands. This technique is called “subcision filling” and may be repeated efter 3 months or longer.
The filler lifts the scar and long term results are good, even after the HA filler is slowly absorbed by your skin enzymes. Another option used for subdermal treatment of widespread scarring or deep atrophy or agerelated fat loss is overdilute Sculptra, which is a more permanent filler that lasts up to 5 years – or even longer. Sculptra is made of Poly-L-Lactic Acid and it induces formation of new collagen.
Sculptra itself will not raise the scars significantly, but over 3-6 months the effect will be visible as collagen forms under the scars. Sculptra could be used as the foundation with early subcision followed by HA fillers with latter subcision for individual scars.
Can more treatments be combined for acne scars in the same session?
As part of an individual acne scar revision program, subcision can be combined with fractional and resurfacing laser treatments, RF microneedling, TCA cross, chemical peels, etc.
Different treatments may be performed at the same day. Dr. Emil Henningsen treats each scar type with a specific treatment method.
Before & After Subcision
Pricing of treatment with subcision & filler
Subcision and 1 mL HA filler of the cheeks – DKK 5.000 / Euro 675
Subcision and 1 mL HA filler of the cheeks and upper face – DKK 6.000 / Euro 800
Extra fee for 1 vial Sculptra – DKK 1.000 / Euro 135
Extra fee for sedation – DKK 1.000 / Euro 135
FAQ about treatment with subcision & filling
Many patients are surprised how quick they recover after subcision and fillers.
Allow 2-3 days for the swelling to go away completely. Most swelling is due to the local anesthesia (often 10 mL injected).
After Nokor subcision, some bruising may remain for up to 2 weeks.
This is quite easy. Subcision happens primarily under the skin surface. Most of the surface is left unharmed and intact.
Only little punctures in the skin will be visible as small crusts that peel in 3-5 days.
Simply wash your skin with a facial cleanser or mild soap in the morning and evening and apply a gentle moisturizer (eg. Cicaplast or Cicalfate).
Bruising may be covered with make-up the first day after subcision. Avoid smoking for the first few days (impairs healing).
All fillers may cause lumps and bumps, which usually is temporary.
HA fillers may be gently massaged in circular motions just one minute twice daily. Start after the filler and swelling has settled (usually after 2-3 days). If no lumps are felt or seen you may leave the filler as is.
Overdilute Sculptra MUST be massaged in order to avoid lumps. We strongly advise you to massage for two minutes, twice daily for 2 weeks (2-2-2-rule). Use a moisturizer on the skin as a glide medium.
Do not massage downwards, as Sculptra is used with field subcision in larger areas, and Sculptra should not migrate to the lower face due to gravity and manipulation.
We strive to achieve optimal results with paramount safety and follow-up. However, there is a risk with any surgical procedure.
Subcision is performed in different skin layers with a risk of damage to blood vessels (redness, swelling, bruising, bleeding) and an extremely low risk of damaging the nerves (neuropraxia).
Infection and scars is a risk whenever the skin surface is compromised. The risk is very low.
Rarely, a lump is felt after a few weeks. This could be a hematoma. Hematomas usually fade overtime. The process may be accelerated with repeated massage, hot dressing or by intake of Aspirin orally.
Alternatively, your GP or dermatologist can inject a small amount of corticosteroid hormone or Hyalase into the hematoma.
Allergic reaction have been reported to anesthesia. Please report to us if you suffer from allergy to local anesthetics (Lidocain or Xylocain).
Skin colour changes (hyop- og hyperpigmentation) are extremely rare after subcision and are most often seen in darker skin types after sun exposure post-treatment.
Hyaluronic fillers may be dissolved with Hyalase injections. Sculptra can not be dissolved.
Therefore, we do not recommend that you do Sculptra at your very first treatment session. Start with HA fillers and see if you like the result. Go for Sculptra at the latter treatment sessions.
The result of subcision and filling is an immediate reduction of depressed scars.
3 months after treatment with subcision and fillers, laser treatments with fractional Erbium or CO2 laser or RF microneedling may be performed – this will improve your skin texture and reduce superficial scars due to collagen formation.
We suggest that you meet up for treatment without makeup. Men should cut or shave the beard one day before arrival.
You are welcome to wear headphones and listen to your own music during the procedure.
Subcision is not suitable for people who form wide, thick scars (keloids).
If you have a skin infection, you can not be treated.
If you are pregnant you also cannot have the treatment.
If you have allergies to anesthesia we have the possibility of sedating you.
You can book online here>
Dr. Henningsen is available for appointments Wednesday, Thursday and Friday in Cutis Clinic Odense (close to Odense Central Station)
If in doubt, please call the clinic at +45 7020 7066 (press 9 for English) on weekdays between 8:30-11:00 am or 2:00 – 4:00 pm.
or send us an e-mail at: email@example.com
Do you have questions or want to book an appointment?
We are looking forward hearing from you