Subcision

Subcision, also known as subcutaneous incisionless surgery, is a technique used to improve the appearance of depressed, tethered scars, most commonly rolling and pitted acne scars. These scars form when healing produces fibrous strands of collagen beneath the skin, which anchor the surface downwards and create a dimpled, uneven appearance that topical treatments and resurfacing lasers alone cannot correct.

The procedure works beneath the skin rather than on it, targeting the cause of the depression rather than the surface texture. It is performed under local anaesthetic, and while it is most frequently used on the face, it can be used to treat tethered scarring elsewhere on the body. Depending on the depth and severity of the scarring, a course of one to three treatments is usually recommended.

Once the area has been numbed with topical anaesthetic, a fine needle is passed just beneath the scar. This is used to break the fibrous bands that are holding the scar down, releasing the tension that pulls the skin inward, and lifting the scar. Dermal Filler is then injected under each individual scar, smoothing the skin and preventing the reformation of scar bands. 

The treatment prompts the skin to produce new collagen in the area, supporting the depression over the weeks and months that follow.

Subcision addresses the structural cause of depressed scarring rather than simply resurfacing the skin above it, making it one of the few treatments capable of meaningfully improving rolling and tethered scars. Results are long-lasting, although repeat Dermal Filler treatments will be needed to achieve the best outcome.

It is a minimally invasive procedure carried out under topical anaesthetic, with no incisions, no stitches and a short recovery period. Because it works at a different level to laser resurfacing, microneedling and radiofrequency treatments, it complements rather than duplicates them, and can be integrated into a wider scar treatment plan. It is suitable for all skin types, including deeper skin tones where certain laser treatments carry a higher risk of pigmentation.

Subcision is most commonly performed on the face, particularly the cheeks and temples where rolling acne scars typically occur but it can also be used on the jawline and neck. 

Yes. Subcision is effective as part of a combination approach. It is frequently paired with polynucleotides to support the released tissue, and with resurfacing treatments such as UltraClear®, Morpheus8 and microneedling to refine surface texture once the underlying tethering has been released. Regenerative treatments such as Exosome Therapy and PRP may also be used to support healing.

There is minimal downtime with Subcision. There can be raised bumps or redness from injection points, however, this can subside within a couple of hours. There is a chance of bruising and/or swelling, which usually appears within 48 hours from the treatment. To minimise bruising we suggest avoiding omega-3 fatty acid supplements, blood thinners and alcohol for 48 hours prior to injectable treatments. 

This is offered in London, in our Harley Street, Belgravia, City and Liberty clinics, and our Edinburgh clinic