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Skin › Acne Scars

Subcision Acne Scars Treatment

What is Subcision?

Subcision is a minor surgical procedure used to treat depressed (atrophic) acne scars. The technique involves the insertion of a specialized medical-grade needle or cannula beneath the scar tissue.

By performing horizontal movements, the practitioner severs the fibrous bands that tether the surface of the skin to the underlying subcutaneous tissue. The release of these bands allows the skin to retract upward, while the subsequent wound-healing response stimulates the synthesis of new collagen in the vacant space.

FeatureDetails
Best ForRolling scars and deep boxcar scars
Duration30 to 60 minutes
Recovery5 to 7 days for bruising to fade
Cost in SGGenerally ranges from $400 to $1,200+ per session, depending on area size and add-ons

What is Acne Scars?

Subcision is most effective for rolling scars. These are characterized by broad depressions with sloping edges that give the skin a “wavy” texture. Because these scars are caused by internal tethering, they respond better to subcision than to surface-level treatments.

Rolling Scars
Boxcar Scars
Ice-pick Scars
Appearance
Rolling acne scars
Boxcar acne scars
Ice-pick acne scars
Description
Wide, shallow depressions that create a "wavy" texture.
Round or oval craters with sharp, vertical edges.
Tiny, deep holes; looks like the skin was punctured by a needle.
Width
Wide, up to 4 to 5mm.
Medium to wide.
Very narrow, under 2mm.
Depth
Shallow.
Shallow to medium depth.
Very deep; often extends into the deep dermis.
The "Stretch Test"
Disappears or flattens out when the skin is stretched taut.
Usually stays visible when stretched.
Does not disappear when you stretch the skin.
Response to Subcision
Most effectivePrimary indication
Moderate improvementOften combined
Not suitableTCA CROSS instead

Suitability for Diverse Skin Tones

Type I
Ivory / Pale White
Always burns, never tans.
Type II
Fair / White
Burns easily, tans minimally.
Type III
Light Brown / Olive
Sometimes mild burns, tans uniformly.
Type IV
Moderate Brown
Burns minimally, always tans well.
Type V
Dark Brown
Rarely burns, tans very easily.
Type VI
Deeply Pigmented
Never burns, tans very easily.

One of the primary advantages of subcision acne scars treatment is its safety profile across all Fitzpatrick skin types. Unlike some laser resurfacing treatments which may carry a higher risk of Post-Inflammatory Hyperpigmentation (PIH) in darker skin tones, common in Singapore’s demographic, subcision bypasses the epidermis. This reduces the risk of thermal damage and pigmentary changes.

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Pre-Treatment Considerations: Active Acne

Patients must have their acne in a state of remission before undergoing subcision acne scars treatment in Singapore.

Performing surgical intervention in the presence of active inflammatory acne increases the risk of:

  • Bacterial translocation and infection
  • Interruption of the healing cascade
  • The formation of new acne lesions and subsequent scarring

The Subcision Treatment Process

Technical Modalities: Needle vs. Cannula

Nokor Needle

Sharp, tri-beveled

Designed for precise cutting. It is highly effective for localized, dense fibrous bands, but may involve a higher incidence of bruising (ecchymosis).

Blunt-Tip Cannula

Flexible, non-sharp

Requires fewer entry points and is associated with reduced trauma to blood vessels and nerves, typically resulting in shorter recovery periods.

Clinical Instructions After Subcision

A post-care guide for patients who have completed subcision at The Clifford Clinic. Follow these instructions alongside any specific advice given by your doctor.

Immediate Post-Procedure Care

Hemostasis
If a compression bandage has been applied, keep it intact for the first 2 to 4 hours to minimize the risk of hematoma.
Cold Therapy
Apply a cold compress to the treated area for 10 to 15 minutes every hour for the first 24 hours to reduce edema and ecchymosis (bruising).
Analgesia
For minor discomfort, Paracetamol may be taken. Avoid Aspirin or Ibuprofen for 48 hours as these may increase bruising.

Wound Management & Hygiene

Cleansing
You may gently cleanse your face 12 hours post-procedure with a mild, pH-balanced cleanser. Pat dry with a clean towel; do not rub.
Sun Protection
Apply a broad-spectrum physical sunscreen (SPF 50 or higher) daily. This is critical in preventing UV-induced pigmentation of bruised areas.
Topical Care
If prescribed, apply an antibiotic ointment or recovery cream to the entry points twice daily for 3 days.

Activity Restrictions (Days 1 to 7)

Physical Exertion
Avoid strenuous exercise and heavy lifting for 5 days to prevent secondary swelling.
Environmental Exposure
Avoid saunas, steam rooms and swimming pools for 1 week to reduce the risk of infection.
Skincare
Discontinue use of Vitamin C, Retinoids and Chemical Exfoliants (AHA/BHA) until all entry points have fully epithelialized, usually 5 to 7 days.

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Our Doctors

Dr. Gerard Ee

Dr. Gerard Ee is the founder and medical director of The Clifford Clinic. He is fully accredited in cosmetic treatments and has extensive experience in acne scar revision.

Dr. Chow Yuen Ho

Dr. Chow Yuen Ho is the founder and medical director of The Clifford Clinic. With over 10 years of clinical practice, he has performed a wide range of aesthetic and medical procedures.

Frequently Asked Questions

The procedure is generally well-tolerated because doctors use local anesthesia (tumescent anesthesia). You will feel a few pinpricks during the numbing process, but after that, you should only feel a sensation of pressure or a “snapping” sound as the bands are released.

The social downtime is typically 3 to 7 days. Erythema (redness) and swelling are most prominent in the first 48 hours. Bruising usually transitions from purple to a faint yellow by day 5, at which point it can be covered with corrective makeup.

Cosmetics can typically be applied 48 hours after treatment, provided the entry points have closed. Ensure all application tools are sanitized.

Many doctors in Singapore recommend Subcision with fillers, or Subcision with Rejuran S.

Once the bands are cut, a “pocket” is created. If left empty, the bands may re-attach. Injecting a filler or a collagen stimulator acts as a spacer to prevent re-tethering while your body produces its own collagen.

Yes. Once the fibrous bands are cut and new collagen fills the space, the lift is generally permanent. However, results are gradual and continue to improve over 3 to 6 months as collagen remodels.

No. Most Singaporean doctors will insist on treating active inflammation first, to prevent the spread of bacteria and the risk of infection during the subcision process.