Staring at stubborn acne scars in the mirror each morning can be disheartening, but there’s hope beyond concealer and foundation. Subcision has emerged as one of the most effective minimally invasive treatments for depressed scars, offering genuine improvement where other treatments often fall short.
This guide covers what you need to know about subcision, from how it works to what you can expect during recovery. Whether you’re battling rolling acne scars or considering your treatment options, understanding this procedure could be the first step towards smoother, more confident skin.
What is Subcision and How Does It Work?
Subcision addresses the root cause of depressed scars by targeting the fibrous bands that tether or anhors scar tissue to deeper layers of skin. This innovative technique works by mechanically breaking these restrictive connections, allowing the skin to naturally lift and smooth out over time.
The Subcision Procedure Explained
During subcision, a qualified practitioner uses a specialised needle or cannula to carefully separate the scar tissue from the underlying structures. The procedure begins with thorough cleansing and local anaesthesia application to ensure patient comfort throughout the treatment.
The practitioner inserts the needle or a blunt cannula beneath the skin at specific angles, moving it back and forth to break the fibrous bands whilst creating space for new collagen formation. This controlled micro-trauma stimulates the body’s natural healing response, encouraging fresh collagen production that gradually fills in the depressed areas. The use of collagen stimulators or fillers to bolster the tissue as it heals improves outcomes and can reduce the need for subsequent sessions of subcision to reach the optimal effect.
The entire procedure typically takes 30-60 minutes, depending on the number and size of scars being treated. Most patients experience minimal discomfort during the procedure thanks to effective local anaesthesia.
Once scars are released, they stay permanently as such, making the procedure a worthy consideration in view of its long term benefits.
Subcision vs. Other Scar Treatments
- Subcision vs. Laser Treatments: Lasers use thermal energy to treat the skin’s surface. Subcision works deeper by mechanically cutting the fibrous bands that physically pull scars down.
- Subcision vs. Chemical Peels: Peels are effective for improving surface texture and mild discoloration but cannot release the deep tethers causing depressed scars.
- Subcision vs. Dermal Fillers: Fillers provide an immediate but temporary volume lift. Subcision offers a more permanent, natural improvement by stimulating your body’s own collagen production.
- Subcision vs. Microneedling: While microneedling stimulates new collagen, it cannot break the tough, fibrous bands holding scars down. The two treatments are often combined for superior results—subcision releases the scar, and microneedling refines the skin’s texture.
Types of Scars Subcision Treats Best
Highly Effective For:
- Rolling Scars: Subcision is the ideal treatment for these wave-like scars, often leading to a 70-90% improvement after a series of sessions.
- Shallow Boxcar Scars: These also respond very well because subcision directly targets the underlying fibrous tethers that cause the depression.
Less Effective / Requires Combination Therapy:
- Deep Boxcar Scars: May need to be combined with other treatments, like lasers or fillers, for the best outcome.
- Ice Pick Scars: As these scars are too narrow and deep, subcision alone is not effective. It can, however, be used as part of a larger treatment plan that includes other methods like chemical peels or laser therapy.
Is Subcision Painful?
Pain tolerance varies among individuals, but most patients find subcision quite manageable with proper anaesthesia and preparation. Understanding what to expect can help alleviate anxiety and ensure a comfortable treatment experience.
Pain Levels During Subcision Treatment
Most patients describe the sensation during subcision as mild pressure or tugging rather than sharp pain. The local anaesthesia effectively numbs the treatment area, making the procedure comfortable for the vast majority of patients.
The initial needle insertion for anaesthesia may cause brief discomfort, similar to any injection, but this quickly subsides as the area becomes numb.
Some patients experience mild anxiety rather than actual pain, particularly if they’re needle-sensitive. Discussing concerns beforehand allows practitioners to implement additional comfort measures as needed.
Anaesthesia Options and Pain Control
- Local Anesthesia: This is the primary method used. An injection of a local anesthetic, like Lidocaine, is administered to completely numb the treatment area, ensuring a comfortable procedure.
- Topical Anesthetic Cream: For enhanced comfort, a numbing cream is often applied to the skin 30-60 minutes before the injection to minimize the initial needle prick.
- Sedation for Anxious Patients: Depending on the clinic, options like oral sedatives (a pill) or nitrous oxide (“laughing gas”) may be available to help particularly anxious patients relax.
Post-Treatment Pain and Discomfort
Post-procedure discomfort typically ranges from mild to moderate, peaking within the first 24-48 hours before gradually subsiding. Most patients compare it to bruising pain or muscle soreness rather than sharp, acute pain.
Over-the-counter pain relievers such as paracetamol or ibuprofen usually provide adequate relief. Cold compresses applied intermittently during the first day can help reduce both pain and swelling.
The treated area may feel tender to touch for several days, but this sensitivity decreases progressively as healing advances. Most patients return to normal activities within 2-3 days with minimal discomfort.
Subcision Recovery Time and Aftercare
Proper recovery planning ensures optimal healing and treatment results whilst minimising potential complications. Understanding the healing timeline helps set realistic expectations for your subcision journey.
How Long Does Subcision Take to Heal?
Subcision Healing Timeline
- First 7-10 Days (Initial Recovery): This is the period for surface healing. Most visible bruising and swelling will resolve during this time.
- 4-6 Weeks (Early Improvement): As initial swelling fully subsides, the first signs of improvement become noticeable as your body starts building new collagen.
- 3-6 Months (Optimal Results): The most significant results are typically seen in this timeframe. The new collagen has matured, lifting the depressed scars and smoothing the skin’s appearance.
- 6-12 Months (Full Healing): The complete tissue remodeling process can continue for up to a year, with subtle improvements still possible as the skin fully regenerates.
What to Avoid After Subcision Treatment
- Sun Exposure: For at least 2 weeks, avoid direct sun exposure as it can interfere with healing and cause skin darkening (hyperpigmentation). Always use a broad-spectrum sunscreen of at least SPF 30 when outdoors.
- Strenuous Exercise: For 48-72 hours, avoid activities like heavy lifting, intense cardio, hot yoga, or visiting saunas. These can increase blood flow and worsen swelling and bruising.
- Alcohol and Smoking: Avoid alcohol for at least 48 hours to reduce the risk of bruising. It is strongly recommended to stop smoking, as it significantly impairs the skin’s ability to heal.
Managing Bruising and Swelling
- Timeline: Expect bruising to be at its worst around days 2-3 and then gradually fade over 7-14 days. Swelling and bruising will vary for each person.
- Cold Compresses: During the first 24 hours, apply a cold compress (wrapped in a cloth) for 10-15 minutes every few hours. This will help minimize initial swelling.
- Warm Compresses: A warm compress can be used to aid in the settling of the bruising and swelling from day 2 to day 5.
- Elevate Your Head: For the first few nights after treatment, sleep with your head elevated on extra pillows to help reduce facial swelling.
- Arnica: You can consider using arnica supplements or topical creams, as some people find they help lessen bruising.
Who is a Good Candidate for Subcision?
A good candidate for subcision is determined by scar type, skin health, and overall medical history.
Ideal candidates typically have:
- Rolling or shallow boxcar acne scars.
- Good skin elasticity and healing capacity.
- Realistic expectations, understanding that results appear gradually over several months.
- An age range between their 20s and 40s, though this is not a strict limit.
Subcision may NOT be suitable for individuals who:
- Have severe, active acne or other skin infections in the treatment area.
- Are prone to keloid or hypertrophic scarring.
- Have blood clotting disorders or are taking blood-thinning medications, which requires careful medical evaluation.
Subcision Cost and Pricing Breakdown
Average Cost in Singapore:
- Per Session: Typically ranges from SGD 600 to SGD 1,500.
- Addition of fillers or collagen stimulators: Depending on the type of product used, additional cost of SGD 300 to SGD 1800 can be expected. The addition of such stimulating agents, done with a thorough subcision technique, can reduce the need for subsequent subcision sessions.
Factors That Influence the Price:
- Practitioner’s Experience: Doctors with experience and who tend to subcise more thoroughly tend to charge more.
- Treatment Complexity: Larger areas or deeper, more challenging scars will increase the cost.
- Clinic Location: Clinics in prime locations with state-of-the-art facilities often have higher fees.
Can subcision be combined with other treatments?
Yes, subcision works excellently in combination with other scar treatments. Many practitioners combine it with microneedling, laser therapy, or chemical peels for enhanced results. Dermal fillers can also be used immediately after subcision to provide additional volume and smoother results.
Will my scars completely disappear after subcision?
Whilst subcision provides excellent improvement, complete scar elimination is rarely achievable with any single treatment. Most patients experience 70-90% improvement in rolling scars, with the skin appearing much smoother and more even. Realistic expectations are crucial for treatment satisfaction.
How soon can I wear makeup after subcision?
Light makeup can typically be applied 24-48 hours post-treatment, once any bleeding has stopped and initial healing has begun. Use clean brushes and gentle products to avoid irritating the treated area. Heavy foundation or concealer should be avoided for the first week.
Is subcision suitable for all skin colours?
Subcision is generally safe for all skin types and colours. Unlike some laser treatments, subcision doesn’t rely on heat energy that can cause pigmentation changes in darker skin tones. However, post-inflammatory hyperpigmentation can still occur, particularly in skin types prone to pigmentation changes.
What's the difference between subcision and surgical scar revision?
Subcision is a minimally invasive procedure performed in-office under local anaesthesia, whilst surgical scar revision typically requires more extensive incisions and longer recovery times. Subcision works by releasing fibrous bands rather than removing tissue, making it less invasive with lower complication rates.
Can subcision treat stretch marks?
Whilst subcision primarily targets facial acne scars, it can sometimes help with certain types of stretch marks, particularly those with tethered or depressed areas. However, stretch marks respond better to other treatments like microneedling or laser therapy. A consultation can determine the best approach for your specific concerns.
How long do subcision results last?
Subcision results are generally permanent because the procedure releases fibrous bands and stimulates new collagen formation. However, natural ageing processes continue, and new acne breakouts could potentially create fresh scarring. Maintaining good skincare and sun protection helps preserve results long-term.
Are there any serious risks or complications?
Serious complications from subcision are rare when performed by experienced practitioners. Temporary side effects include bruising, swelling, and mild pain. Very rarely, patients may experience infection, nerve damage, or irregular scarring. Choosing a qualified, experienced practitioner minimises these risks.
Can I have subcision if I'm currently using retinoids or other acne medications?
Some medications may need to be temporarily discontinued before subcision. Topical retinoids may be paused for 3 days before and after the procedure. Always disclose all medications during your consultation.
What should I do if I'm not happy with my subcision results?
If results are less than expected, discuss options with your practitioner. Additional sessions may be beneficial, or combination treatments might be recommended. Sometimes results continue improving for several months, so patience is important. Dr Shane offers follow-up consultations to assess progress and discuss further options if needed.
Why choose Dr Shane for Subcision Treatment in Singapore?
Subcision can be a powerful tool—but only when done right. Don’t self-diagnose or choose a clinic based purely on price.
At Dr Shane’s clinic, we believe remarkable results begin with three fundamentals: medical precision, honest advice, and customised care.
While many clinics focus on selling treatments, we prioritise:
- In-depth 1-1 skin health consultations (at least 30 mins)
- HSA/FDA-compliant protocols using approved devices with documented safety profiles
- Personalised energy settings adjusted for your unique skin thickness and concerns
What makes our approach different?
✔ Doctor-Led Consultations
Every treatment plan begins with a medical evaluation of your skin’s needs – not a sales conversation.
✔ Safety-First Philosophy
We use only HSA-approved devices and disclose all potential risks transparently.
✔ No Pressure, Just Professional Advice
You’ll leave your consultation either:
- Confident this treatment is right for you, or
- Aware of better alternatives for your goals
✔ Natural-Looking Results
Our treatment plans prioritise gradual, authentic improvement over dramatic but short-lived changes.
✔ Continued Aftercare
Post-treatment guidance to help maintain and optimise your results
The First Step is Always a Conversation
Many patients discover during consultation that their skin concerns actually require:
→ A different treatment approach
→ Combination therapies
→ Or simply more time before considering procedures
Book a skin health assessment to get professional insights before deciding on any treatment.
Let us help you find what’s right for your skin—not just what’s trending.
Secure your skin health consultation slot with Dr Shane today
Great skin starts with the right diagnosis.