Skin & Aesthetics · Acne scars
Subcision for Acne Scars: Releasing Tethered Rolling Scars in Seoul
Subcision is a minor procedure for depressed acne scars in which a doctor slides a fine needle or blunt cannula under the scar to cut the fibrous bands that tether it to deeper tissue, letting the skin lift and new collagen fill the space. At Hommage Clinic in Gangnam, Seoul, Dr. Hwang Seonhwa checks which scars are tethered and usually combines subcision with resurfacing.
Quick answer
Subcision is a minor procedure that frees depressed acne scars by cutting the fibrous bands tethering them from below, using a fine needle or blunt cannula under local anesthetic. At Hommage Women's Clinic in Gangnam, Seoul, Dr. Hwang Seonhwa performs it in about 20–45 minutes, mainly for rolling scars, usually with RF microneedling. Expect 1–2 weeks of bruising, 1–3 sessions 4–8 weeks apart, and gradual improvement over 2–3 months.
Key takeaways
- Subcision treats the cause of tethered scars, which surface treatments cannot reach.
- It works best for rolling scars; ice pick scars need other methods.
- Needles, cannulas, wires and blunt blades are all used; choice depends on scar depth.
- Bruising and temporary lumps are common; some bands re-form and need a repeat.
Infographic
Subcision in numbers
Procedure time
Depends on the number of scars treated.
Sessions
About 4–8 weeks apart, as some bands re-form.
Bruising
Most people work the next day.
To final result
New collagen supports the lifted skin.
Reported response
Range reported for rolling scars in the literature.
Tool types
Needles, cannulas, wires and blunt blades.
Subcision at a glance
| Key fact | Details |
|---|---|
| Treatment time | Usually 20–45 minutes, depending on the number of scars |
| Anesthesia | Local anesthetic injection, often after numbing cream |
| Sessions | Typically 1–3 sessions about 4–8 weeks apart, often with other treatments |
| Downtime | Bruising and swelling for about 1–2 weeks; most people work the next day |
| Results visible | Some lift early; final result after about 2–3 months as collagen forms |
| How long results last | Released scars usually stay improved; some bands re-form and need repeat |
| Performed by | Dr. Hwang Seonhwa or another Hommage Clinic physician |
Subcision may suit you if you have
- Rolling scars: soft, wide dips that look worse in side lighting
- Scars that flatten noticeably when you gently stretch the skin
- Some broad boxcar scars with a tethered base
- Acne that has been controlled for a few months
Wait or discuss another option if you have
- Active acne, infection or cold sores in the area
- A bleeding disorder or blood-thinning medication (discuss first)
- Pregnancy, or a keloid tendency
- Mainly narrow ice pick scars, which need a different method
How does subcision work?
When a deep acne lesion heals, fibrous bands can form between the underside of the skin and the fat beneath it. These bands act like anchors, pulling the surface down into a wide dip called a rolling scar. Resurfacing treatments work on the skin surface and dermis, so they cannot cut these bands.
In subcision, the doctor inserts a fine needle or a blunt-tipped cannula through a tiny entry point and moves it in a fan-like pattern just under the scar, at the junction of the dermis and fat. This does two things:
- Releases the tethering bands , so the skin is no longer pulled down.
- Creates a small, controlled pocket of healing , in which new collagen forms over the following weeks and supports the lifted skin.
Because it acts below the scar rather than on the surface, subcision is usually combined with treatments that remodel the skin itself.
Which acne scars does subcision treat?
Subcision is mainly a treatment for tethered scars. A simple test is to stretch the skin gently around the scar: if the dip softens or disappears, tethering is likely.
- Rolling scars: the main indication, and often the scars that respond most visibly. See rolling scar treatment .
- Broad boxcar scars: some have a tethered base and lift partly after subcision, with resurfacing for their sharp edges. See boxcar scar treatment .
- Ice pick scars: too narrow for subcision; they respond better to TCA CROSS . See ice pick scar treatment .
Raised scars and keloids are not treated with subcision.
What happens during subcision?
Subcision is done in the treatment room under local anesthesia. A typical visit takes about an hour.
- With you sitting upright under angled light, the physician marks the tethered scars, because some are hard to see when you lie down.
- Numbing cream may be applied, then a small amount of local anesthetic is injected into each area.
- A fine needle or cannula is inserted through a tiny entry point and moved under each scar until the bands are released.
- Firm pressure and cold packs are applied to limit bleeding and bruising. The entry points are tiny and usually do not need stitches.
You may feel pressure and a snapping sensation as bands release, but sharp pain should be limited by the anesthetic.
Subcision with RF microneedling, fillers and other treatments
Most acne scar specialists treat with a combination, because subcision releases the scar while other methods rebuild the skin over it. Common pairings include:
- RF microneedling for scars , done in the same session or a few weeks later, to remodel the dermis over the released scar.
- Classic microneedling or fractional laser to smooth texture and edges.
- Fillers or collagen stimulators , such as hyaluronic acid filler, Juvelook or Radiesse, placed under released scars to add support and help reduce re-tethering. See collagen stimulators .
- TCA CROSS for any ice pick scars in the same area, usually in separate sessions.
Your doctor will set the order and spacing so that each treatment has time to heal before the next.
How long does subcision take to heal, and how long do results last?
Expect swelling for a few days and bruising for about 1–2 weeks. Some scars look lifted right away because of swelling and fluid under the skin, then settle slightly before collagen builds over the next 2–3 months.
Results from released bands are usually long-lasting, but some bands re-form, so 1–3 sessions about 4–8 weeks apart are common. Scars become shallower and less visible rather than completely gone. For the first week:
- Use cold packs for the first 24–48 hours and sleep with your head slightly raised.
- Avoid alcohol, saunas and hard exercise for several days to limit bruising.
- Wear makeup once the entry points have closed, usually after 1–2 days.
- Follow any massage instructions you are given, and use SPF 30+ daily.
Risks and possible side effects
Subcision is a well-established procedure, but it involves cutting under the skin. Dr. Hwang will go through these risks before you consent:
- Bruising and swelling : expected, and sometimes marked for the first week.
- Firm lumps or nodules under treated scars, which usually soften over weeks; occasionally treatment is needed.
- Temporary numbness or tingling in the treated area.
- Hematoma , a collection of blood under the skin, which may need draining.
- Infection , uncommon with sterile technique.
- Post-inflammatory hyperpigmentation at entry points or over bruises, more likely in darker skin.
- Scars that re-tether and need another session.
Contact the clinic promptly if swelling keeps increasing, a lump becomes hot or very painful, or you develop pus or a fever.
Subcision at Hommage Clinic
Hommage Clinic is a women's health and skin clinic in Gangnam, a short walk from Sinnonhyeon Station. Scars are assessed and marked by a physician, who performs the subcision and plans any combined resurfacing or injections, such as Juvelook or Radiesse, as one program. Scar treatment starts once acne is controlled, withacne treatmentfirst if needed. You can see related options in ourskin and aestheticsservices.
Cost depends on the number of scars, the number of sessions and any combined treatments. Cosmetic scar treatment is not covered by Korea's National Health Insurance, although many medical tests and treatments are for enrolled patients. You receive a written quote before treatment, and walk-ins are welcome during opening hours.
How it works
How subcision works: the fan-shaped release under a scar
The skill in subcision is in the plane and the pattern. The instrument enters through a single tiny puncture beside the scar and travels flat, just beneath the skin at the junction of the dermis and fat. From that one point it sweeps back and forth in a fan, cutting the strands that hold the scar down while leaving the skin above intact. A 2023 review describes four families of tools for this: sharp needles, blunt cannulas, wires and blunt-blade instruments, chosen by scar depth and the doctor's preference.
Preparation
How to prepare for subcision
Because subcision deliberately causes a small bleed under each scar, preparation focuses on bleeding risk and timing. Scars are marked while you sit upright under angled light, so arriving without makeup helps. The checklist below covers what to tell the doctor and how to plan your calendar around the bruising.
- List every medicine and supplement Including aspirin, blood thinners, fish oil, vitamin E and ginkgo. Do not stop prescribed medicine without advice.
- Mention cold sores Preventive medicine may be advised if you get them around the mouth.
- Avoid alcohol the day before It can increase bruising.
- Come without makeup Scars are easier to see and mark on bare skin.
- Clear your calendar Allow about 1–2 weeks before important events or photos.
- Arrange a quiet first evening Rest with cold packs and your head slightly raised.
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
Tethered scars are marked while you sit upright, before the anesthetic. Illustrative photo.
Comparing options
Needle vs cannula subcision: which is better?
Classic subcision uses a sharp needle, such as a tri-beveled 18-gauge needle or a triangular-tipped Nokor needle. Many clinics now also use blunt-tipped cannulas, which tend to push past blood vessels rather than cut them. In a 2018 split-face study of 34 patients with rolling scars, patients were more satisfied with the blunt cannula side at three months (about 58% vs 42%), and the needle side had more bruising and nodules. The study was small, and the authors said evidence was not yet enough to call cannulas the standard. A 2013 review also noted that thinner needles caused less trauma and hematoma than thick ones.
| Compare | Sharp needle | Blunt cannula |
|---|---|---|
| How it releases | Cuts bands with a sharp edge | Breaks bands with a rounded tip in a wider sweep |
| Best for | Small, firm, well-defined tethers | Wider rolling areas |
| Common effects | Bruising; firm nodules more often | Swelling; usually less bruising |
| Evidence | Long track record since the 1990s | Small comparative studies favor it on comfort |
Recovery
Subcision recovery timeline and results
Recovery after subcision follows a recognizable pattern. Early swelling can make scars look better than they will be a week later, and small firm areas under treated scars are common while the new tissue organizes. Nodules from extra healing tissue often resolve without treatment in about 2–3 months, according to a 2013 review.
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
A quiet first evening with cold packs helps limit bruising. Illustrative photo.
Aftercare
Subcision aftercare: do's and don'ts
The first 48 hours shape how much you bruise. After that, aftercare is mostly about patience while the new tissue forms. Some clinics give gentle massage instructions for firm areas; follow only the advice you are given for your treatment.
Do
- Use wrapped cold packs for 24–48 hours
- Sleep with your head slightly raised
- Keep entry points clean until closed
- Use broad-spectrum SPF 30+ daily
- Follow any massage advice you are given
- Contact us if a lump is hot or keeps growing
Don't
- Drink alcohol for the first few days
- Do hard exercise, saunas or hot yoga
- Take extra aspirin-type pain relief unless advised
- Press or massage without instructions
- Book events or photos within two weeks
- Judge the result in the first week
Combination plans
Subcision plus resurfacing: building a combined acne scar plan
Subcision rarely works alone. A 2023 review of subcision focused on both the tools used and the combination treatments paired with it, and the studies on this page mostly tested subcision alongside microneedling or laser. The logic is simple: release first, then rebuild. Releasing the tethers lets the skin rise; resurfacing then improves the quality of the skin over the scar; and support from volume can help a released scar stay up.
A typical order
- Control active acne first, withacne treatmentif needed.
- Subcision for tethered rolling scars, sometimes with RF microneedling on the same day.
- TCA CROSS for any ice pick scars, in a separate session.
- A resurfacing series withRF microneedlingorfractional laserto smooth texture.
- Optional volume where scars stay soft but sunken.
The exact order is set for your scars and schedule, with each step given time to heal before the next.
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
Subcision and resurfacing are usually planned together as one program. Illustrative photo.
Evidence
Does subcision work? What the research says
Subcision is one of the oldest acne scar procedures still in daily use, and a 2023 review in Clinical, Cosmetic and Investigational Dermatology concluded it is a particularly effective treatment for atrophic acne scars. Most supporting studies, however, are small, single-center and use different tools and combinations, so the figures below are best read as a range of experience rather than precise predictions.
Rolling scar response
Range of effectiveness reported for subcision in rolling scars.
Küçüktaş et al., J Turk Acad Dermatol, 2013Improved a grade
43 of 45 patients after 4 monthly sessions of subcision plus microneedling.
Bhargava et al., J Clin Aesthet Dermatol, 2019Cannula vs needle
Patient satisfaction at 3 months in a 34-patient split-face study.
Gheisari et al., J Cosmet Dermatol, 2018Lumps settle
Nodules from extra healing tissue often resolve without treatment.
Küçüktaş et al., 2013Traveling to Seoul
Subcision in Seoul for international patients
Subcision is a single-visit procedure, but bruising is the main thing to plan around when traveling. Many visitors schedule subcision, often with RF microneedling, early in their stay so that the worst bruising has passed before sightseeing or the flight home. A follow-up review after 4–8 weeks can be done in person on a return trip, or by sending photos.
Planning your visit
- Send daylight photos of your cheeks from the front and both sides by WhatsApp, KakaoTalk or the contact form.
- Plan at least 7 days in Seoul after subcision; allow up to two weeks if you want bruising to fade before you travel.
- Bring your passport and a full list of medicines and supplements, especially blood thinners.
- Avoid long-haul flights in the first 24–48 hours if you can, while swelling is at its peak.
Hommage · Seoul
Hommage Women's Clinic · Gangnam, Seoul
Seoul: the clinic is in Gangnam, a short walk from Sinnonhyeon Station. Illustrative photo.
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
You receive a written plan and quote before treatment. Illustrative photo.
Choosing well
How to choose a clinic for subcision
Subcision is a hands-on procedure where the doctor's judgment of which scars to release, and how far, matters more than any device. Ask these questions at any consultation, including ours:
- Does a physician perform it? Subcision is a needle procedure under local anesthetic.
- Which of my scars are tethered? A good answer uses the stretch test and angled light.
- Needle, cannula or both? Ask why the tool suits your scars.
- What is combined with it? Resurfacing or volume often adds to the result.
- How are bruising and lumps managed? You should know what is normal and when to call.
- Do I get a written plan and quote? Including the likely number of sessions.
What affects the cost of subcision?
Cost depends on the number and extent of tethered scars, the number of sessions, and whetherRF microneedling, filler or acollagen stimulatoris added. Cosmetic scar treatment is not covered by Korea's National Health Insurance, and you receive a written quote before treatment.
Your visit
What to expect at your subcision appointment
01
Scar assessment
Scars are checked sitting upright under angled light, and tethered scars are identified with a gentle stretch test.
02
Your plan
You agree on subcision and any combined RF microneedling, laser or fillers, with a written quote.
03
Treatment
After local anesthetic, each marked scar is released, then pressure and cold packs are applied.
04
Follow-up
Healing is reviewed after a few weeks, and further sessions or resurfacing are timed from there.
Your doctor
Dr. Hwang Seonhwa
Physician · Skin & Aesthetic Treatments
Dr. Hwang identifies tethered scars with you sitting upright under angled light, since these are easy to miss lying down. Subcision is usually planned together with resurfacing so that released scars are also remodeled at the surface.
Physician for face and skin procedures, including lifting, laser and skin-improvement treatments, planned around facial proportions and skin condition.
Subcision for acne scars: frequently asked questions
What does subcision do for acne scars?
Subcision releases the fibrous bands that pull acne scars down from underneath. Once the bands are cut, the skin can lift, and new collagen forms in the treated space over the following weeks. It is most useful for rolling scars and some broad boxcar scars, and it is usually combined with resurfacing such as RF microneedling.
Does subcision hurt?
The procedure is done under local anesthetic, so most people feel pressure and a snapping or scraping sensation rather than sharp pain. The anesthetic injection itself stings briefly. Afterward the area can feel sore and bruised for several days, which simple pain relief such as acetaminophen usually manages.
How many subcision sessions will I need?
Many people need 1–3 sessions spaced about 4–8 weeks apart, because some fibrous bands re-form after the first release. The number depends on how many scars are tethered and how deep they are. Combining subcision with fillers or collagen stimulators may help reduce re-tethering.
How long does bruising last after subcision?
Bruising usually lasts about 1–2 weeks and can be noticeable for the first few days. Cold packs for 24–48 hours, avoiding alcohol and hard exercise, and sleeping with your head raised can help. Concealer can be used once the tiny entry points have closed, usually after 1–2 days.
Do subcision results last?
Yes, released scars usually stay improved, because the tethering bands are cut and replaced by new collagen. However, some bands re-form, so a repeat session is sometimes needed, and the skin continues to age over time. Subcision softens scars rather than erasing them, so most people combine it with resurfacing for a fuller result.
Can foreigners get subcision in Seoul?
Yes. International patients and foreign residents can book subcision at Hommage Clinic; bring your passport for registration. Plan for 1–2 weeks of possible bruising and a follow-up visit a few weeks later, so allow enough time in Seoul or plan to return. Please contact us before your visit to arrange language support.
Is a cannula or a needle better for subcision?
Both work. A small 2018 split-face study found patients preferred blunt cannula subcision and had less bruising and fewer nodules than with a Nokor needle, but the authors said more evidence is needed. Many doctors use a needle for small, firm tethers and a cannula for wider areas, choosing per scar.
What are the lumps after subcision?
Small firm bumps under treated scars come from new healing tissue and are common. They often soften without treatment over about 2–3 months. If a lump is large, persistent, hot or painful, contact the clinic; occasionally a small injection or other treatment helps.
Can subcision be done with RF microneedling on the same day?
Often, yes. Combining subcision with RF microneedling in one visit means one recovery period, and the two work on different layers. Sometimes they are spaced a few weeks apart instead, depending on your skin, the number of scars and how much bruising you can accept.
Does subcision work for ice pick scars?
Not usually. Ice pick scars are narrow, deep tracts rather than tethered dips, and studies combining subcision with microneedling found they improved little. They respond better to TCA CROSS or punch techniques. See ice pick scar treatment.
Will I have marks from the needle entry points?
Entry points are tiny, usually close within a day or two and rarely need stitches. In skin that darkens easily, a small brown mark can appear at an entry point or over a bruise and usually fades over weeks to months with sun protection.
Is subcision safe if I take blood thinners?
Blood thinners increase bruising and the risk of a hematoma, so tell the doctor about every medicine and supplement before booking. Never stop a prescribed blood thinner on your own. Your doctor may adjust the plan, treat fewer scars per session, or suggest a different approach.
Should I add filler after subcision?
Some scars stay soft but sunken after release because tissue has been lost. A small amount of filler or a collagen stimulator placed under the released area can add support and may help reduce re-tethering. It is optional and discussed once your doctor sees how the scars respond.
References
Sources used for this page, reviewed by Dr. Hwang Seonhwa. Read our editorial and medical review policy.
- Vempati A, Zhou C, Tam C, et al. Subcision for atrophic acne scarring: a comprehensive review of surgical instruments and combinatorial treatments. Clin Cosmet Investig Dermatol. 2023.
- Küçüktaş M, Engin B, Kutlubay Z, Serdaroğlu S. Subcision treatment of acne scars. J Turk Acad Dermatol. 2013;7(3):1373r1.
- Bhargava S, Kumar U, Varma K. Subcision and microneedling as an inexpensive and safe combination to treat atrophic acne scars in dark skin: a prospective study of 45 patients. J Clin Aesthet Dermatol. 2019;12(8):18–22.
- Gheisari M, Iranmanesh B, Saghi B. Split-face comparison of blunt cannula and Nokor needle subcision for rolling acne scars. J Cosmet Dermatol. 2018 (as reported by Dermatology Times).
- Jacob CI, Dover JS, Kaminer MS. Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol. 2001;45(1):109–117.
This page is general information and does not replace a personal consultation. Illustrations are original works of Hommage Women's Clinic, Gangnam, Seoul; photos marked illustrative are not of patients.
Related acne scar treatments
Rolling Scar Treatment
The scar type subcision treats most, and how it is combined with resurfacing.
RF Microneedling for Scars
Remodels the dermis over released scars; often paired with subcision.
TCA CROSS Treatment
The usual method for narrow ice pick scars that subcision cannot reach.
Boxcar Scar Treatment
Sharp-edged scars that may need subcision, resurfacing or TCA CROSS by depth.
Collagen Stimulators
Injectables such as Juvelook and Radiesse that add support under depressed areas.
Microneedling for Acne Scars
Classic heat-free needling to smooth texture after subcision.
Find out whether your scars are tethered
Book an appointment with Dr. Hwang Seonhwa in Gangnam for a scar check under angled light and a written plan for subcision and any combined treatment.
Hommage Clinic · 4F, Building A, 509 Gangnam-daero, Seoul (near Sinnonhyeon Station) · Mon & Fri 10:00–20:00 · Tue–Thu 10:00–19:00 · Sat 10:00–15:00