Surgical Subcision for Acne Scars: A Review of Instrumentation

Abstract

BACKGROUND Subcision is a surgical technique for managing atrophic acne scars. Over time, new instruments have emerged to increase the efficiency, efficacy, and safety of the subcision procedure, including sharp, blunt, and energy-assisted devices. OBJECTIVE To review the instrumentation used for the subcision of acne scars and to provide clinicians with practical information regarding the selection of instrumentation, with a focus on advantages and disadvantages. METHODS A search of PubMed, MEDLINE, and Google Scholar was conducted for articles from January 2000 to June 2022 describing the use of subcision alone for the management of acne scarring. Demographic and clinical data were collected from the included articles. RESULTS A total of 417 patients from 17 articles were included; 155 patients underwent sharp subcision, 235 patients underwent blunt subcision, and 27 patients underwent energy-assisted subcision. The main indication for subcision was atrophic facial acne scars. Subcision using sharp, blunt, and energy-assisted instruments were all effective in treating atrophic acne scars. Adverse effects common to all subcision methods included erythema and edema. CONCLUSION Subcision is a safe and effective modality for the revision of selected acne scars and is a valuable skill set for dermatologists who perform scar revision to master.