Rolling acne scars are held down from below by fibrous bands. Medical Director Dr Sin Yong releases them with subcision and plans surface work around it at Pacific Plaza, Orchard Road.
WhatsApp to Enquire →Key facts ↓Subcision is a procedure that frees rolling acne scars from the fibrous bands tethering them to deeper tissue. Under local anaesthetic, a fine blade-tipped needle or blunt cannula is passed beneath the scar through a tiny entry point to cut the bands, letting the skin rise. It is usually combined with CO2 laser or RF microneedling for the surface.
Acne scars come in different shapes. Ice-pick scars are narrow and deep; boxcar scars are wider with steep edges; rolling scars are broad, soft undulations that give the cheek a wavy look in side light. Rolling scars are pulled down by fibrous bands that join the underside of the skin to deeper tissue, so polishing the surface above them changes little.
Dr Sin Yong examines the skin in different lighting and uses the stretch test: if a scar softens when the surrounding skin is stretched, the band underneath is the problem, and subcision is likely to help. Most faces have a mix of scar types, so subcision is usually one part of a wider plan. See acne scar treatment.
Subcision lifts the floor of a tethered scar; resurfacing works on the surface and the scar edges. A common sequence is subcision first, then fractional CO2 laser on the DEKA platform or RF microneedling weeks later once bruising has settled, repeated across a course. Some plans place them in the same session; Dr Sin Yong decides by scar depth, skin type and how much downtime you can take.
For mixed scarring, these steps may sit inside IN Eternity Clinic’s layered 4D Scar Reconstruction protocol. Where scars have lost volume, a collagen stimulator placed beneath them after release can add support. For a comparison of the resurfacing options, read CO2 vs RF microneedling vs pico for acne scars.
“Laser polishes the surface. A rolling scar is held down from below, so the band has to be released first.”
Numbing cream is applied first, then local anaesthetic is injected into each treated area, which stings briefly. After that, most people feel pressure and a dull scraping or tugging sensation rather than sharp pain. The face can feel tender and swollen for some days afterwards; simple painkillers such as paracetamol are usually enough.
Day 0: scars are mapped and marked, local anaesthetic is given, and subcision is performed through tiny entry points. A firm, cool compress helps limit swelling.
Days 1–3: swelling and bruising are at their most visible; the treated scars may look raised or lumpy. Keep the entry points clean and avoid strenuous exercise.
Week 1: bruising changes colour and starts to fade; make-up can usually be used once entry points have closed.
Weeks 2–4: bruising resolves for most people; early collagen formation begins under the released scars.
Review at about four to six weeks: scars are reassessed in the same lighting, and resurfacing or a further subcision session is planned.
Bruising and swelling are expected. Less often, a firm lump (a small collection of blood or excess collagen) can form and usually settles with time or simple treatment. Infection is uncommon. Post-inflammatory pigmentation can follow in darker skin, so sun protection is part of aftercare. Subcision is deferred while acne is active, during or soon after oral isotretinoin as advised individually, in pregnancy, and in people with bleeding disorders or taking blood thinners without medical advice.
Rolling scars are the type most likely to improve with subcision, because they are caused by fibrous bands pulling the skin down. Releasing those bands lets the skin rise, and new collagen forms underneath. Results vary with scar depth and skin, and improvement builds over a course rather than a single session.
Many people need two or three sessions, spaced about four to eight weeks apart, often alternating with laser or RF microneedling. Some scars re-tether as they heal and need a repeat release. Dr Sin Yong reviews the scars after each session before planning the next.
Bruising and swelling usually last about one to two weeks, peaking in the first few days. Avoiding blood-thinning supplements beforehand where medically safe, using cold compresses and resting from strenuous exercise for a few days can help. It is sensible to plan around important events.
Sometimes. Combining them in one session shortens the overall timeline but adds to swelling and downtime. Often subcision is done first, with resurfacing a few weeks later. The choice depends on your scar types, skin type and schedule, and is made at assessment.
Cost depends on how many scars or areas are treated, whether subcision is combined with laser or RF microneedling, and how many sessions are planned. Dr Sin Yong explains the full plan and its cost after mapping your scars, rather than quoting a single procedure in isolation.
People with active inflammatory acne, a current skin infection, a bleeding disorder, or who are pregnant should wait. Those on blood-thinning medicine, recent oral isotretinoin, or with a tendency to keloid scarring need individual advice first. Your medical history is reviewed at consultation.
IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, Singapore 228210. By appointment with Medical Director Dr Sin Yong. Monday to Saturday, 11am to 8pm. WhatsApp or call +65 8815 3008.
These sources describe mechanisms and general evidence. They are not a promise of any individual result; suitability is decided at an in-person assessment.