Compare · Procedures

Scar Revision vs Subcision

Scar Revision: The whole set of procedures used to make an existing scar less noticeable — cutting it out and closing it more neatly, flattening it, releasing it, or resurfacing it. No procedure erases a scar. Revision trades the scar you have for one you would rather live with.

Subcision: A needle passed under an indented acne scar to cut the strands holding it down, so the surface can lift. It is aimed at rolling scars specifically, it bruises, and it is almost always combined with something else.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist
Last updated: 10/22/2026
Editorial illustration for Scar Revision, based on the entry’s treatment or equipment reference.Editorial illustration for Subcision, based on the entry’s treatment or equipment reference.
Choose ifKey differencesWhat is it?What it treatsTreatment areasSkin tonesHow it worksBefore your treatmentDay of treatmentAfter your treatmentRisksCostQuestionsRelated

Choose Scar Revision if…

Choose to trade a scar you dislike for a neater one — no procedure erases a scar.

  • A wide, raised or puckered scar
  • The scar is at least a year old
  • You accept a new, better-placed scar

Choose Subcision if…

Choose for rolling acne scars that are tethered down, usually combined with needling, laser or filler.

  • Soft, wavy rolling scars
  • Scars that improve when you stretch the skin
  • You can hide a week or two of bruising
Alternatives, not combined

Can you have both?

They suit different scars. Subcision releases tethered acne scars; scar revision surgically remakes a larger scar.

Key differences

● Scar Revision
● Subcision
DowntimeNone → 2+ weeks
1–2 weeks
1–2 weeks
PainMinimal → Needs anesthesia or sedation
Moderate
Moderate
Results showImmediately → 3+ months
3+ months
1–3 months
How long it lastsWeeks → Years or permanent
Years or permanent
Years or permanent
Visits neededOne → Every few months
A short series (2–3)
A short series (2–3)
Cost per visit$ → $$$$$
$$$
$$
ReversibleYes, can be undone → No, permanent
No, permanent
No, permanent

What is it?

Scar Revision

Subcision

What is it?

It improves scars.

It aims to improve appearance, comfort or movement.

It uses several methods.

Surgery, injections and resurfacing may be combined.

It does not erase scars.

It modifies scar tissue rather than restoring unscarred skin.

Keloids need special care.

Excision alone can cause a larger recurrence.

It releases scar bands.

Fibrous bands tethering depressed scars are cut beneath the skin.

It suits rolling acne scars.

It is not for every pit, mark or raised scar.

It is minor surgery.

It is performed by a clinician with a needle or blade.

History is reviewed.

Bleeding risk, scarring tendency and isotretinoin use are assessed.

What it treats

Evidence level
Scar Revision
Subcision
Strong evidenceMost established uses
Scars on light skin.

Scars

Improves width, texture and color.

Rolling Scars.

Rolling Scars

Releases tethered scars.

Moderate evidenceSome supportive research
A raised, smooth, firm scar on the upper chest on light skin. It is shiny pink-red and hairless, and its edges spread well past the small mark it grew from.

Keloids

Combined with injections to prevent return.

Acne scarring on light skin. Small sharply cut pits and broad shallow dips across a cheek, several sitting inside faint flat pink marks, with no active spots.

Acne Scarring

Punch excision for deep scars.

Acne scarring on light skin. Small sharply cut pits and broad shallow dips across a cheek, several sitting inside faint flat pink marks, with no active spots.

Acne Scarring

Best for rolling scars.

Educational illustration of natural shallow dimpling of adult lateral-thigh skin below the hem of shorts on light skin.

Cellulite

Releases dimples.

Little evidence
Two areas of fair skin side by side on a hip. New pink-red bands sit above, and older flat silvery-white bands below, with only a small difference in color between the pale marks and the skin around them.

Stretch Marks

Usually treated with lasers or needling.

Educational illustration of healed broad indented scars with defined edges on the left cheek, with the face turned to the person’s right on light skin.

Boxcar Scars

Better treated with resurfacing.

Not effective
—
Ice Pick Scars on light skin.

Ice Pick Scars

Too narrow to release.

Treatment areas

Treatment areas

The specific lesion, scar or affected patch determines the treatment site; there is no fixed body distribution.

Selected facial scars; the highlighted cheeks show the general treatment area.

Skin tones

Skin tone
● Scar Revision
● Subcision
Lighter skin
Low risk
Scar fades over a year.
Low risk
Bruising.
Medium skin
Some risk
Dark marks possible.
Low risk
Bruising may leave brief dark marks.
Deeper skin
Higher risk
Keloids can return larger; injections or radiation are often combined.
Low risk
One of the lower pigment-risk scar treatments.

How it works

Scar Revision

Subcision

How it works
Scar Revision mechanism diagram. The scar is assessed: Its shape, location, and tension guide the surgical plan. Tissue is revised or rearranged: A surgeon changes the scar and carefully closes the wound. A new scar matures: Appearance may improve, but scar tissue remains.
Subcision mechanism diagram. A scar is tethered below skin: Fibrous bands can pull a rolling scar downward. The bands are released: A clinician passes an instrument beneath the scar. Repair follows the release: The depression may improve as the tissue heals and remodels.
Diagram explanation

The scar is assessed: Its shape, location, and tension guide the surgical plan. Tissue is revised or rearranged: A surgeon changes the scar and carefully closes the wound. A new scar matures: Appearance may improve, but scar tissue remains.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

A scar is tethered below skin: Fibrous bands can pull a rolling scar downward. The bands are released: A clinician passes an instrument beneath the scar. Repair follows the release: The depression may improve as the tissue heals and remodels.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

Before your treatment

Scar Revision
Subcision
Earlier planning

6 to 12 months: Waiting: Surgeons want 6 to 12 months of natural settling first.

6 months before: After isotretinoin: Most providers wait about 6 months before subcision, though this is debated and some treat sooner.

2–4 weeks before

Sun: Keep the scar out of the sun and use SPF 30 or higher.

2 weeks before: Smoking and vaping: Stop both at least two weeks before and after surgery.

2 weeks before: Sun: Keep the area out of the sun and use SPF 30 or higher.

Before you book: Timing: Get active acne under control first, or new scars form beside the treated ones.

The week before
Not specified

Actives and supplements: With your prescriber's agreement, stop blood-thinning supplements such as fish oil, vitamin E and ginkgo.

Day of treatment

Scar Revision
Subcision
Before you arrive

What to bring: Old photos: Photographs from before the injury, if you have them.

Not specified
Arrival & prep

The scar is photographed and examined relaxed and stretched.

Photographs first, then the skin is stretched and lit from the side so tethered scars stand out.

Treatment

A steroid injection takes minutes and meets real resistance.

Surgical revision cuts the scar out as a narrow ellipse and closes it in layers, usually 30 to 90 minutes. A Z-plasty swaps small flaps to change direction. Punch excision removes a small round scar. Laser or microneedling takes 20 to 45 minutes. Expect pressure, not sharpness.

A tiny entry point is made beside the scar, and the needle or cannula is passed underneath and moved side to side in a fan until the skin releases.

You feel pressure, tugging and a faint crunching as the strands give way. Firm pressure follows to limit bruising, and filler or microneedling may follow. Usually 15 to 45 minutes, and once numb it is pressure, not pain.

Before you leave

Tape over the line, wound care instructions, and a date for stitch removal — 5 to 7 days on the face, 10 to 14 days on the body.

Swollen, red and firm, with the treated scars looking temporarily better from the swelling.

After your treatment

Scar Revision
Subcision
First 24 hours

First 2 weeks: Swollen, bruised and tender.

Days 1 to 3: Deep purple bruising appears and spreads downward with gravity, worst around day two or three.

Days 2–7
Not specified

Days 4 to 14: The bruises turn green and yellow, and concealer covers them reasonably well from about day three, once the entry points have sealed.

Weeks 2–4

Weeks 2 to 8: The new line turns pink, firm and slightly raised — normal healing, not failure.

Weeks 2 to 12: Small firm lumps can be felt as the scar tissue remodels, and most soften on their own.

Beyond 1 month

Months 3 to 18: Redness fades and the ridge softens from month 3 to 6, with massage and silicone doing the work.

Not specified
Time to results

Over 6–12 months

1–3 months

How long results last

Permanent

Long-lasting

Risks

Risks
  • A scar thickening or spreading again
  • Itching, burning or tenderness in the scar
  • A dent or pale patch after an injection
  • A new dark patch
  • Numbness or odd sensation
  • A firm lump that is growing
  • Bruising that keeps expanding
  • A new brown mark
  • A cold sore outbreak
  • A scar that looks deeper afterward

Cost

Per session

In the US this varies more than almost any other dermatology procedure, because "scar revision" covers a five-minute injection and a ninety-minute operation.

In the US, subcision commonly runs a few hundred dollars per session, and the price rises when filler, microneedling or radiofrequency needling is added — filler is often the larger part of the bill.

Insurance

Insurance often pays when a scar limits movement or vision, interferes with function, or follows cancer surgery or an injury.

Insurance almost never covers subcision for acne scars, because scar treatment for appearance is cosmetic.

Questions

Scar Revision

Subcision

Individual Questions
Can a scar be removed completely?

No. Every treatment replaces the scar with a different one — flatter, narrower, paler, or running in a less obvious direction. Often a large improvement, not removal.

How long should I wait before revising a scar?

Usually 6 to 12 months, because most scars keep improving on their own in that time. Scars that limit movement and raised scars still growing are treated sooner.

What is the difference between a keloid and a hypertrophic scar?

A hypertrophic scar is raised but stays within the original wound borders and often flattens over a year or two. A keloid grows beyond them, keeps going, and does not settle by itself. Keloids come back after surgery much more often, so they are usually injected rather than cut.

Will scar revision help my acne scars?

Some of them. Rolling scars respond to subcision, needling and laser; deep icepick scars often need punch excision or a targeted acid technique; boxcar scars sit in between. Expect a course and partial improvement, not one operation.

Does insurance cover it?

Sometimes — when the scar restricts movement or vision, causes symptoms, or follows cancer surgery or trauma. Revision for appearance is cosmetic. Ask the office to check with your insurer before you book.

I have deeper skin tone, and I keloid. Is anything safe?

Yes, but the order changes. Injections, silicone and pressure come first, elective surgery on high-risk sites is approached carefully, and if a keloid is removed, something is always done alongside to control the healing. Tell the provider at the first visit.

How do I know if my scars are the right type?

Stretch the skin either side of the scar, or press gently beside it. If the dip flattens out, it is tethered, and that is the scar subcision treats. Scars with sharp punched-out edges that stay put when you stretch are icepick or boxcar scars and need something else.

How long does the bruising last?

Usually 7 to 14 days. It looks worst around day two or three, then turns green and yellow, and concealer works from about day three. Plan for two clear weeks, not one.

Will one session be enough?

Usually not. Most courses are 2 to 4 sessions, 4 to 8 weeks apart. Some of the immediate improvement is lost as cut strands reattach, and the gain builds over the course.

Do I need filler with it?

Not always, but many providers add it. Filler holds the released space open while new collagen forms, which reduces retethering. Ask what would be used, how much, and what it adds to the cost.

Does it hurt?

The numbing injections sting for a few seconds and are the worst part. After that it is pressure and tugging, not sharp pain. The area is sore for a day or two, like a deep bruise.

Is it safe on deeper skin tones?

Yes, and it is often a good choice, because it uses no heat or light. The thing to manage is a temporary brown mark where the bruising was. Sun protection, limiting the bruising and spacing sessions all help.

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