Scar subcision

Subcision is a procedure in which a doctor inserts a specialized needle beneath the skin to sever the fibrous tissue bands tethering the base of atrophic scars to deeper tissues, allowing the scar base to be released and elevated. It is primarily indicated for rolling scars; usually requires 1–3 sessions spaced 4–6 weeks apart, with bruising lasting 5–10 days, and is often combined with lasers or microneedling.

Medically reviewed by BS.Ths.CKI Kim Kha — BonBoz Clinic

Mechanism

Rolling scars appear depressed because underlying fibrous bands pull the base of the scar downward. A subcision needle (Nokor needle or cannula) is inserted through a small puncture point and moved in a fanning motion beneath the scar to sever these tethering fibrous bands. The resulting hematoma and natural wound-healing cascade stimulate new tissue formation to fill the void, lifting the scar base to a more elevated position. This is a subdermal invasive procedure performed under local anesthesia and must be conducted by a physician.

Who Is It Suitable For?

Rolling scars—scars that flatten out when the skin is stretched; deep boxcar scars with fibrous tethering; and elongated linear scar tracks caused by acne or chickenpox. It is not suitable for ice pick scars (which lack fibrous tethers and require TCA cross), keloids, or actively inflamed skin.

Why Is It Often Combined with Other Treatments?

Subcision releases the tethered scar base, but the overlying skin surface still requires resurfacing—which is addressed by fractional CO2 laser, microneedling RF, or traditional microneedling. In certain cases, physicians may inject temporary dermal fillers or PRP into the subcised space to prevent re-tethering. The treatment sequence and intervals between sessions are tailored based on individual clinical response.

Sessions and Recovery

Typically, 1–3 sessions spaced 4–6 weeks apart are required for a target area. Bruising and swelling for 5–10 days are normal and indicate adequate subcision; mild soreness may persist for a few days. Visible improvements develop gradually over 4–8 weeks as the newly formed tissue stabilizes.

At BonBoz

Our dermatologists assess your skin using a stretch test to identify tethered scars, map the target areas, administer local anesthesia, and perform the subcision using sterile specialized needles. A light compression dressing is applied along with detailed post-care instructions; follow-up visits and a coordinated schedule for complementary laser or microneedling treatments are established accordingly.

How is it performed?

Marking the scar areas under skin tension, followed by antiseptic cleansing and local anesthesia (injection). The doctor inserts a specialized needle through a small entry point, sweeping it horizontally beneath the scar base to release the fibrous bands — you may feel pressure or tightness, but no sharp pain; the procedure takes 20–40 minutes. A light pressure bandage is applied for a few hours.

Before the procedure

Discontinue anticoagulants/aspirin as directed by your prescribing physician; avoid alcohol for 24 hours prior (to minimize bruising); disclose any history of keloid scars, herpes, or bleeding disorders; ensure inflammatory acne is controlled beforehand; arrive with clean skin.

After the procedure

Noticeable bruising and swelling for 5–10 days — apply cold compresses for the first 48 hours, avoid vigorous massaging; mild soreness for 2–3 days; needle entry points heal within a few days; apply sun protection; avoid strenuous exercise and saunas for 1 week. Follow-up appointment in 4–6 weeks, combine with laser/microneedling treatments as scheduled.

Possible risks — your doctor explains them before treatment

Bruising and swelling for 1–2 weeks (normal)
Hematoma, temporary subcutaneous induration/nodules lasting a few weeks
Infection due to improper aftercare (rare)
Damage to small vessels/nerves if performed in the incorrect plane — the reason an anatomically knowledgeable doctor is required
Partial re-adhesion, requiring repeated subcision
Thin, highly vascular skin carries a risk of prolonged bruising

Who should NOT have this?

Ice-pick scars are the primary concern (no tethering/fibrous bands)
Coagulation disorders or currently on unadjusted anticoagulant therapy
History of or predisposition to keloid scarring
Active inflammatory acne or skin infections in the treatment area
Currently pregnant (postpone treatment)
Excessively thin or atrophic skin in the treatment area

BS.Ths.CKI Kim Kha

Aesthetic Dermatology

Graduated as a General Practitioner — Tay Nguyen University (2018)
Specialist Level I in Dermatology — Pham Ngoc Thach University of Medicine, degree awarded in 2025
Medical Practicing Certificate No. 009784/ĐL-CCHN — Issued by the Department of Health of Dak Lak Province on 15/10/2021
Over 8 years of experience in aesthetic dermatology practice (since 2018), including over 4 years of practice with an official Medical Practicing Certificate
Primary Specialization in Plastic and Reconstructive Surgery; Certificates in Dermatological Procedures & Minor Surgery, Microsurgery, and Lasers & Light Therapies in Dermatology
Certificates in Dermal Fillers, Botox, and Thread Lifts; Certificates in Emergency Resuscitation and Infection Control
Formerly practiced at the Aesthetic Dermatology Unit — Post and Telecommunications General Hospital (2019–2021) and Venus Sunrise Clinic (2022–2024) before joining BonBoz Clinic (2025)
Former lecturer in Aesthetic Dermatology Theory at Ana Aesthetic Training School (2018–2019)
Over 5,000 clinical dermatology cases treated

Đặt lịch với bác sỹ

Book a consultation with a doctor

Choose a date, time slot and doctor — the clinic calls to confirm within 5 minutes during opening hours. Free consultation, no commitment.

Full name

Phone number

Preferred date · Preferred time · Doctor

Preferred date

Preferred time

Doctor

The clinic will call to confirm within 5 minutes during opening hours (08:00–20:00, daily). This is not yet a confirmed slot.

I agree to let BonBoz contact me for consultation using the information I provided, and I have read the Personal Data Protection Policy.

You do not have to describe your health condition here — you can discuss it directly with the doctor at your visit.

Free consultation — no obligation, no sales pressure.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Frequently asked questions

Is subcision painful?

Local anesthesia is applied, so you will mainly feel pressure and tightness during the procedure. Afterwards, mild soreness for 2–3 days and bruising are normal.

How long does bruising last?

Typically 5–10 days, though it can last up to 2 weeks depending on individual healing. Applying a cold compress for the first 48 hours helps reduce it.

Is one session enough?

Many scars require 2–3 sessions because fibrotic bands can partially reattach; the doctor will evaluate your progress after 4–6 weeks.

Is laser treatment needed after subcision?

Usually yes, to smooth the skin surface and stimulate collagen production. The doctor will determine the treatment sequence based on your specific skin condition.

How does subcision differ from microneedling?

Microneedling targets the surface from the top down, while subcision cuts the fibrous bands beneath the skin—two different objectives that often complement each other.

Will it leave scars at the needle entry points?

The entry points are extremely small and typically heal without a trace; tiny dots rarely remain.

Can I undergo subcision while taking aspirin?

You must consult your prescribing physician to adjust the medication a few days in advance to reduce the risk of bruising and hematoma; do not stop taking it on your own.

How long until I see results?

Once the bruising subsides (around 2 weeks), the scar base will appear more elevated; results stabilize after 4–8 weeks.

Is filler injected into the subcised area?

In some cases, the doctor may place temporary fillers or PRP to prevent reattachment—this depends on specific clinical indications and is not mandatory.

Who performs the procedure at BonBoz?

A board-certified Dermatologist directly performs the procedure—this is a subdermal invasive technique and is never delegated to technicians.