Acne (and other) scar subcision

Cystic acne creates inflamed nodules deep in the skin. 

These inflamed nodules heal with time, but often leave permanent indents on the surface of the skin and strands of scar tissue binding the surface of the skin to deeper structures such as deeper fat or even the deeper connective/muscle tissue layer (SMAS or subcutaneous musculo-aponeurotic system). 

These persisting tethering strands of scar tissue keep the surface looking indented. The indents appear particularly under tangential light such as downlight.

Subcision is a straightforward procedure using the edge of a 21g or 19g needle (under local anaesthetic) to divide these strands of scar tissue, thus releasing the indents to adopt a flatter position.

Cellulite is like a Chesterfield lounge.

You remember those old-fashioned chairs and lounges? Typically leather, firm, stuffed with stuffing and with the sitting surface held down by a lot of buttons?

Cellulite is like that.

Lumpy fatty stuffing with dimples creating little dips in between the stuffing.

And the essential two ways you can smooth cellulite is by either reducing the lumps or by reducing the dips.

Reducing the dips is like *cutting the buttons of a Chesterfield lounge*

And *that* is subcision.

Acne: after cleansing the skin and photographing the starting position I carefully mark the scars we intend to treat. Local anaesthetic is then spread under the scars and allowed time to take effect.

Once completely numb, I introduce through the skin a 21G needle and move the needle in such a way as to divide the scar tethers. We then witness the scars become flatter.

Cellulite: you stand up, showing me the areas requiring treatment.

I photograph the area, clean it, and mark out the dimples requiring subcision (I'll do what I can, but I often cannot do them all).

You then lie on the treatment couch, and I inject local anaesthetic into the dimples I'm going to treat.

Once they are properly anaesthetised, I use a needle like a Nokor needle or the bevel of a 19G needle to slice, under the skin, the strands of connective tissue (or "scar") tethering down the dimple.

Often the dimple then pops up.

Or, at least, it is improved.

There *will* be bruising. We can't slice these connective strands without causing bruising. But bruises go away, and without subcision these dips in your acne scars or cellulite will not go away.

Technically, persisting numbness and skin damage could result from subcision, but we have not seen such side effects.

Any surgical scar can heal with tethering and an indented surface. Subcision can help greatly improve the scar surface. 

Appendicectomy scars, caesarian section scars, and liposuction scars we most commonly help with.