Subcision is a minimally invasive procedure designed to improve the appearance of depressed acne scars. The technique involves inserting a specialized needle or cannula beneath the skin to mechanically break the fibrous bands that pull the scar tissue downward. By releasing these deep tethers, the skin surface is allowed to rise, and the controlled trauma triggers the body’s natural wound healing response. This process stimulates the production of new collagen, which works over time to fill the space beneath the scar and smooth the skin’s texture.
The Typical Treatment Range
For most patients, the number of subcision treatments required generally falls into a range of two to four sessions. This average reflects that while some immediate improvement may be visible, the full effect relies on biological processes that unfold over time. Mild or shallow scarring may sometimes be adequately addressed with only one or two procedures.
However, individuals with moderate to severe atrophic scarring typically require multiple sessions to ensure all fibrotic bands are fully severed and sufficient collagen is generated. Subsequent treatments are performed to target residual tethering and maximize long-term dermal remodeling. Consistency within this treatment range is necessary to achieve optimal scar elevation and skin contour correction.
Key Variables Influencing Treatment Count
The exact number of subcision sessions needed is highly individualized, depending on the characteristics of the scarring and the patient. Subcision is most effective for “rolling scars,” which are characterized by broad, shallow depressions caused by deep, underlying tethers. These scars respond well because the procedure directly addresses the root cause by cutting these restrictive bands.
In contrast, deep, narrow “ice pick” scars or certain “boxcar” scars, which have sharply defined vertical edges, are less suited for subcision alone and often require alternative methods. Scars that are older, deeper, or more extensive across a large area of the face will require more sessions to ensure comprehensive release and healing.
Another significant factor is the patient’s individual biological healing response, particularly the capacity for neocollagenesis, which is the formation of new collagen. Some individuals naturally produce a more robust collagen response following the procedure, leading to quicker and greater scar filling. Variations in skin type and the density of the dermal tissue also contribute to how effectively the skin lifts and remodels after each treatment.
The Role of Adjunctive Therapies
Subcision is frequently used as part of a combination approach, and integrating other procedures can directly influence the total number of subcision sessions necessary. Combining subcision with dermal fillers is a common strategy, as the filler material can be injected immediately into the space created by severing the tethered bands. This immediate volume injection helps maintain the physical separation of the fibrous tissue and prevents the scar from reattaching while new collagen is forming.
When a temporary or semi-permanent filler is used, it acts as a scaffold, which can accelerate the improvement and potentially reduce the number of repeat subcision procedures needed. Other adjunctive treatments, such as fractional laser resurfacing or radiofrequency microneedling, improve the skin’s overall texture and stimulate collagen at different depths. These procedures complement subcision by addressing surface irregularities, which, when performed in conjunction, can enhance the final result and lower the overall requirement for repeated subcision treatments.
Incorporating biostimulatory agents like Platelet-Rich Plasma (PRP) or Concentrated Growth Factors (CGF) during the subcision procedure can intensify the healing cascade. These growth factors boost the body’s natural regenerative abilities, leading to a more pronounced and faster collagen remodeling process. This maximized biological response may diminish the total number of physical subcision procedures needed.
Setting Realistic Expectations and Timeline
Understanding the temporal commitment is important for anyone undergoing subcision treatments. A required waiting period is necessary between sessions to allow the skin to fully heal from the controlled trauma and maximize the collagen production stimulated by the procedure. This interval is typically set between four to eight weeks.
Scheduling treatments too close together does not allow sufficient time for the skin’s remodeling processes to occur, potentially limiting the benefit of each session. The medical professional determines the exact waiting period based on the patient’s healing rate and the degree of bruising or swelling. Consequently, a complete course of subcision, which may involve three or four sessions, can span an overall timeline of six to twelve months to ensure the best possible long-term outcome.