Subcision for Acne Scars Singapore | Treatment for Rolling & Tethered Scars
Subcision for Deep Acne Scars in Singapore
If you have rolling, “dented” acne scars that catch the light and look worse in certain lighting, surface treatments alone often will not fix them, because these scars are tethered downward by fibrous tissue.
Subcision is a minor, doctor-performed procedure that releases those tethers from below, allowing the skin to lift and the dent to soften. For many women, addressing old acne scars is finally a priority after the demands of early motherhood ease, or during a midlife reset – and subcision is one of the most direct ways to treat this specific scar type.
How Effective is Subcision for Rolling Acne Scars?
Subcision is specifically for rolling and tethered (depressed) scars; acne scars with sloping edges that create a rolling, uneven surface. It is more effective for rolling scars than for other atrophic scar types (Subcision in acne scarring: a review of clinical trials, J Cosmet Dermatol, 2023).
Subcision is less suited for icepick scars and boxcar scars.
Most women have a mix of scar types, which is why subcision is frequently combined with other treatments. For example, a typical acne scar treatment could look like subcision to release the fibrous strands first, followed by a collagen-stimulating treatment. Dr Sue will map your scars and recommend the right combination.
How Subcision Works
Using a fine needle or blunt cannula, the doctor inserts the instrument horizontally under the scar and moves it to sever the fibrous bands that tether the scar to deeper tissue. The skin is freed to lift back toward the surface, reducing the depth of the depression
The controlled micro-injury triggers the body’s natural wound-healing and collagen response, forming new connective tissue that helps fill the released space over the following weeks.
Subcision for Acne Scars Before and After Expectations
- Softening and lifting of rolling, tethered scars
- A smoother, more even skin surface as collagen rebuilds over subsequent weeks
- Cumulative improvement across a course of treatment
- Best results when combined, where appropriate, with treatments for other scar types
Speak to our doctor
Dr Sue Ho
Aesthetic Doctor, Special Interest in Women’s Health
Lead Doctor, Women’s Health | MB BCH BAO (Ireland)
Dr Sue understands the changes women navigate at each life stage. She will assess your scar type honestly and tell you whether it suits you, or whether a combination approach would serve you better.
What Your Subcision Journey Looks Like
During treatment
Topical numbing cream is applied, and local anaesthetic may be used for comfort. The doctor releases the tethered tissue beneath each scar. A session typically takes 20 to 30 minutes depending on the number of scars treated.
After treatment
Expect some bruising and swelling. This is normal and part of how subcision works; bruising is among the recognised, usually temporary effects of the technique. Bruising can take several days to two weeks to fully settle, so plan around social or work events. Small entry points heal quickly.
Results and treatment schedule
Initial softening is visible as swelling settles, with continued improvement over the following weeks as collagen rebuilds. A course of multiple sessions, spaced several weeks apart, is usually recommended for depressed scars. Results are cumulative.
How Much Does Subcision Cost at Prologue?
Subcision starts from $350 per session. The final cost depends on the number and depth of scars, how many sessions are recommended, and whether it is combined with other scar treatments. These all assessed during your consultation before any commitment.
FAQ
What types of acne scars does subcision treat?
Subcision is best for rolling and tethered (depressed) scars – those with sloping edges and a “dented” look – and is more effective for these than for other atrophic scar types. It is not the ideal treatment for icepick scars or sharp-edged boxcar scars.
Does subcision hurt?
Numbing cream, and often local anaesthetic, is used to keep you comfortable. You may feel pressure or a tugging sensation during the release.
How much bruising should I expect?
Bruising and swelling are expected and normal – they are part of the mechanism and usually temporary. Bruising can last from a few days up to around two weeks, so it is worth scheduling away from important events.
How many sessions of subcision do I need?
Depressed scars usually need more than one session, spaced several weeks apart, because improvement builds as collagen rebuilds. Your doctor will advise based on your scarring.
Why do my old acne scars look worse now that I'm older?
As skin loses collagen and thins with age, depressed scars cast more shadow, and added skin laxity over the years makes older scars look more pronounced.
Can subcision be combined with other treatments?
Yes, and it often is. Because most people have a mix of scar types, subcision is commonly paired with collagen-stimulating treatments or with TCA CROSS for icepick scars.
Is subcision safe after pregnancy or while breastfeeding?
Please disclose pregnancy or breastfeeding at consultation so Dr Sue can advise on timing.
Is subcision permanent?
The released tethers do not simply re-form, but acne scarring is complex and results vary by individual. A realistic goal is meaningful, lasting improvement rather than total erasure.
Why do acne scars look more noticeable in midlife?
Old acne scars often look more noticeable in your 40s and 50s than they did in your 30s. As skin ages and estrogen declines, the dermis loses collagen and thins, so depressed scars cast more shadow and the surface looks less plump and forgiving.
Patients often seek scar treatment many years after the active acne, by which point skin laxity and facial sagging have added to the original atrophic scarring.