- What is Subcision?
Subcision is a minor surgical procedure used for treating depressed skin scars like chicken pox & acne scars. It is also called subcutaneous incisional surgery. The goal is to create a less-noticeable scar. The remaining scar should fade with time. Scar can be improved but cannot be cured.
- How does Subcision work? Subcision is performed using a special hypodermic needle-Nokar Needle inserted through a puncture in the skin surface after giving local anaesthesia. The sharp edge of the needle is used to break fibrotic strands that are pulling the scar to the underlying tissue. The release of the fibrotic strands and new collagen deposition caused by wound healing due to blood clot will lead to cosmetic improvement of the scar.
- Who can undergo subcision?
The decision to perform subcision will depend on the type, location, and severity of scarring; patient preference and expectations; and clinician experience and expectations. Subcision may be used for the treatment of:
- Depressed stretchable scars (due to acne, trauma, surgery )
- Depressed bound down scars (due to acne, chickenpox, trauma, surgery )
- Depressed skin grafts
- Wrinkles
- Cellulite dimples
- How is Subcision performed?
- The area to be treated is cleansed to remove dirt and make-up
- The scar margins may be defined with a surgical marker, adjusting overhead lighting to delineate depressions.
- Local anaestheticis infiltrated.
- A tri-bevelled needle (number 18 or 20 gauge) or a Nokor needle is inserted at an acuteangle adjacent to the scar parallel to skin surface.
- The needle is advanced through the skinand moved back and forth in a fan-like motion. A snapping sound is heard as fibrous bands are cut.
- The needle is rotated and moved again in a fan-like motion
- The needle is removed and squeezed circumferentially around the exit point to prevent large haematoma formation due to bleeding.
- Manual pressure is applied to the wound for several minutes.
- Dressing is applied for one day and removed the next day.
- Antibiotics and anti-inflammatory tablets are prescribed for 2-3 days
- What is the Downtime of Subcision?
The face appears swollen with mild discolouration for 2 to 3 days after the procedure but returns back to normal over a period of 1 week. Make up and camouflage can be used to cover the cut marks.
- What are the possible complications of Subcision?
If proper parameters and normal protocols are followed there will be hardly any side effects, the most common complications are:
Haematoma due to bleeding (a small haematoma is normal)
Hypertrophic scars (5–10%) or keloid scars Infection Temporary hyper pigmentation Lack of improvement in scarring
- What are the Post operative measures?
Dressing will be removed after 2 days. During that time you have to avoid contact with water & keep the area dry. After removing the dressing, wash your face with the given face Cleanser, Use sunscreen SPF 50+every 4th hourly, apply post procedure cream, avoid sunlight strictly, use scarf, dupatta, cap, wide brimmed hat while going out in sunlight.
- When will I see results?
Subcision works by causing your skin to replace the scar tissue by collagen, thus the results are not immediate and depend upon the speed at which your body responds. Typically, improvements are noticed 6-8 weeks after a session.
9. Who cannot undergo subcision?
Subcision may not be suitable in the following circumstances:
- Patients with a history of hypertrophic or keloid scars
- Bleeding or blood clotting disorders (coagulopathy)
- Active bacterialor viral infection