Why are multiple subcision sessions required for acne scars?

Thank you for your question. The number of subcision sessions depends on the severity of the scars.

In assessing severity of scars, I look at Number of Scars/Area and Type of scars. A patient with deeper scars and larger area of scarring would likely require multiple treatment sessions.

To increase the likelihood of treatment success:

1. I routinely perform Subcision using a large-bore needle in addition to collagen stimulating Fillers like Radiesse.

It is important to use a needle of sufficient size to improve the chances of effectively breaking the adhesions.

The down-sides of using a large needle are more bruising and longer recovery time.

2. The experience of the doctor in performing subcision is also key to treatment success.

This is because only the doctor himself can assess if the scars have been adequately treated during the session.

Hope that this helps!

Both doctors have shared excellent practices on how to get the best results with subcision. The fibrous bands that hold down the scar re-attach almost immediately after separating them with subcision.

That is why I either do multiple sessions of subcision without fillers, or else just a couple of sessions with collagen stimulators. Radiesse works very well in my opinion as well. All the best!

The number of subcision sessions really depends on the severity of your scars.

The following is what I explain to my patient, and ultimately its the patients' choice on the treatment option.

Subcision involves the breaking of the adhesions that are tethering to the acne scars, and generally a small amount of fillers is placed in order to:

1) Stimulate collagen (through the use of Radiesse, which is my favourite)

2) Reduce the re-adhesion risk immediately post procedure

For patients with localised rolling scars, 1 session is enough.

For patients with a lot of scars, generalised, or want to do some sort of rejuvenation, a few sessions will be needed.

And I can bet my last dollar that no one can promise that he can break ALL the scars in just one session for a patient with severe acne scarring. We try to break MOST, and then get the patient back again at the next session for the more stubborn areas. Hope this helps!

Winston