Acne scars can have many presentations including hypertrophic or raised scars, atrophic or depressed scars and variants including ice pick scars.
Subcision is a technique used to improve acne scarring by releasing the scarring under the skin. This is a particularly useful technique for broad depressed acne scars. A needle is used to separate the dermis from the subcutaneous layer so the acne scars are no longer bound down. This can be done as a stand alone procedure or in conjunction with laser resurfacing. No sutures are required.
A useful technique particularly for icepick acne scars. A circular punch is used to core out the scar, thereby freeing the tissue around the scar, which is then sutured.
This technique is used to elevate depressed acne scars. A circular punch is used to release the borders of the scar which is then elevated to be flush with the surrounding tissue and often taped into position.
Sometimes scars are not amenable to any other treatment and require surgical removal. The above techniques can sometimes be performed in conjunction with laser resurfacing. However, if scarring is severe and/or extensive, often a two stage procedure is undertaken. The first stage would include surgical modalities followed at lease one month later by laser resurfacing. This approach usually results in more significant improvement. Some patients with more severe scarring can benefit from repeated laser treatments, although it is wise to wait six to twelve months between treatments to allow adequate collagen remodelling to occur in the dermis.
Side Effects and Complications:
Bruising: May occur at the site but usually subsides within a few days.
Swelling: Temporary condition and not harmful. Occasionally the scar can remain elevated above the surrounding skin though this can be managed with massage or injections.
Pain: Minimal. Take Panadol or Panadeine for any discomfort.
Infection: Can occur with any surgical procedure.
The procedure is performed under local or general anaesthesia depending on the extent of the scarring.
Post Operative Care
Steristrips will be applied. No sutures are required. Follow up with the Doctor 7-10 days later.