Subcision for Acne Scars

Some acne scars don't sit on the surface of the skin — they're pulled down from underneath. If your acne scars look like shallow dents or rolling depressions that stretch when you pull the skin tight, fibrous bands beneath the scar are likely tethering it down. No cream, peel, or laser can fully lift a scar that is physically anchored from below. Subcision treats the cause: it releases those bands so the skin can rise back to a smoother, more even level. At FacePlus Plastic Surgery Institute in Lubbock, Dr. Mo Boonipat performs subcision in the office, awake, under local anesthesia — no general anesthesia, no operating room, and minimal downtime.

 

What Is Subcision?

 

Subcision (subcutaneous incisionless surgery) is a minor in-office procedure for depressed acne scars. After the area is numbed with local anesthesia, a fine needle is inserted just beneath the scar and moved in a gentle fanning motion to sever the fibrous bands that tether the scar to the deeper tissue. As the bands release, the scar lifts. The controlled injury beneath the skin also stimulates new collagen formation during healing, which helps keep the scar elevated and improves skin texture over the following weeks to months.

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Who Is a Good Candidate?

 

Subcision works best on:

- Rolling scars — broad, shallow depressions with sloping edges, the classic tethered scar

- Tethered boxcar scars — sharper-edged depressions that are anchored from below

- Scars that flatten or disappear when the skin is stretched (a good home test for tethering)

 

Subcision is not the primary treatment for narrow, deep icepick scars, raised (hypertrophic) scars, or active acne — those need different tools, and treating active breakouts comes first. During your consultation, Dr. Boonipat will map each scar type, because most patients have a mix and the best plans usually combine treatments (see below).

 

What to Expect

 

- Anesthesia: Local numbing only. You are awake and comfortable throughout — this is the same awake approach Dr. Boonipat is known for across his facial procedures.

- Time: Typically 30–60 minutes, depending on the number of scars treated.

- During: You may feel pressure and hear or feel a faint "release" as bands are divided — most patients are surprised by how easy it is.

- After: Expect bruising and swelling in the treated areas for about a week (occasionally up to two). Most patients return to work in 1–2 days and cover residual bruising with makeup after the first few days.

- Results: Some lift is visible once swelling settles; the real improvement builds over 6–12 weeks as new collagen forms.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

How Many Sessions Will I Need?

 

Many patients see meaningful improvement after a single session. Deeper or more numerous scars may benefit from 2–3 sessions spaced at least 6–8 weeks apart. Your treatment plan — and an honest estimate of how much improvement to expect — will be laid out at your consultation. Subcision improves tethered scars substantially, but no treatment erases acne scars completely; our goal is the most natural, even skin possible.

 

Combining Subcision with Other Treatments

 

Because acne scars are rarely one type, subcision is often the foundation of a combination plan:

- Fractional CO2 laser resurfacing — refines surface texture and blends scar edges after the scars are released

- Fat grafting — restores volume under broad, depressed scars using your own fat

- Dermal fillers — can lift individual scars and support the skin while collagen rebuilds

- Microneedling / chemical peels — finishing treatments for tone and superficial texture

 

Sequencing matters: release the tether first, then resurface and refine. Dr. Boonipat will design the order and timing for your skin.

 

Risks and Considerations

 

Subcision is a low-risk procedure, but as with any treatment it carries some: bruising (expected, temporary), swelling, tenderness, temporary firmness or small nodules under the skin that typically resolve, and a small risk of infection or pigment change — which is why sun protection after treatment is essential. If you form keloid or hypertrophic scars, tell Dr. Boonipat at your consultation so the plan can be adjusted.

 

Cost

 

Subcision starts at $1,500 per session. Because most acne-scar plans combine treatments, your exact fee is confirmed at consultation. The consultation fee is credited toward your treatment fee, and financing is available.

 

Frequently Asked Questions

 

Does subcision hurt?

The area is fully numbed with local anesthesia first, so most patients feel only pressure during the procedure. Mild soreness for a few days afterward is normal and managed with over-the-counter pain relief.

 

How is subcision different from microneedling?

Microneedling works on the skin's surface and stimulates collagen, but it cannot cut the fibrous bands holding a scar down. If a scar is tethered, subcision is the step that actually releases it — the two treatments complement each other rather than substitute for each other.

 

When will I see results?

Initial improvement shows as swelling resolves in 1–2 weeks, with continued improvement over 6–12 weeks as collagen remodels. Full benefit of a session is judged at about 3 months.

 

Can subcision treat all my acne scars at once?

All tethered scars in a treatment area can usually be treated in one session. Scars of other types (icepick, surface texture) are addressed with the complementary treatments above, often in a staged plan.

 

Is there any downtime?

Plan for bruising for roughly a week. Most patients are back at work in 1–2 days; schedule your session at least two weeks before photos or major events.

 

Book a Consultation

 

If tethered acne scars have kept you from feeling comfortable in your own skin, subcision may be the missing step. Book a consultation with Dr. Mo Boonipat at FacePlus Plastic Surgery Institute, 12505 Quaker Ave, Suite A, Lubbock, TX — call or text (806) 503-2090, or book through our website, www.facepluspsi.com.

 

As Dr. Boonipat's training at Mayo Clinic taught him: the best interest of the patient is the only interest to be considered. If subcision isn't the right treatment for your scars, we'll tell you — and tell you what is.