The journey to clear skin often hits a stubborn roadblock: facial scars that remain long after wounds have healed or acne has cleared. These depressions, particularly those from cystic acne or injury, can feel like a permanent fixture, resistant to topicals and superficial treatments. In Singapore, where aesthetic medicine is highly advanced, subcision has emerged as a cornerstone procedure for tackling this specific challenge. Dr. Sin Yong, an aesthetic practitioner with a focus on evidence-based techniques, champions subcision as a fundamental step in restoring the skin’s natural contour, offering a mechanical solution to a complex problem.
The Mechanics of a Depressed Scar
To understand why subcision is so effective, one must first grasp why certain scars become depressed. Dr. Sin Yong explains that it’s not simply a matter of lost volume. As the skin heals from significant inflammation, such as a deep blemish, strong, fibrous bands of collagen tissue can form, tethering the top layer of the skin (the dermis) to deeper structures underneath. This anchor-like effect pulls the skin downward, creating a visible pit or rolling scar. These fibrotic bands are the primary obstacle to smoothing the skin’s surface, and they cannot be broken by creams or light-based treatments alone, which primarily affect the surface.
Subcision: A Precise Mechanical Release
Subcision, short for subcutaneous incision, is a minimally invasive procedure designed specifically to address these tethers. Dr. Sin Yong describes it as a precise mechanical release. Using a specialised, fine cannula or needle, he skillfully inserts the instrument just below the skin's surface, directly under the depressed scar. With a gentle fanning motion, the sharp edge of the instrument severs the fibrous bands that are pulling the skin down. This action is tactile and deliberate, allowing the practitioner to feel the release of the tethers, which immediately frees the skin to elevate back to its natural level.
The Immediate Lift and Subsequent Healing
The moment the fibrotic bands are cut, an immediate change occurs. The depressed area is released, allowing the skin to spring upward. Dr. Sin Yong often notes that patients can see a visible improvement even before they leave the clinic. However, the true magic of subcision unfolds in the weeks and months that follow. The controlled minor trauma induced by the procedure triggers the body’s natural wound-healing response. This stimulates the production of new collagen and tissue in the space created beneath the scar, effectively filling the depression from below with the body’s own building blocks, leading to a more sustained and natural-looking elevation.
Ideal Candidates for Subcision in Singapore
Subcision is not a universal solution for all scar types. Dr. Sin Yong identifies the ideal candidate as someone struggling with soft, rolling scars or broader boxcar scars that have a noticeable tethering effect. It is particularly effective for scars that appear shallower when the skin is stretched sideways. The procedure is less suitable for very sharp, ice-pick scars, which may require other techniques like TCA CROSS, or for raised keloid scars. A thorough consultation is essential to determine if a patient’s scarring pattern will respond well to this targeted mechanical approach.
Combining Subcision for Synergistic Results
While powerful on its own, subcision truly shines as part of a combination therapy approach. Dr. Sin Yong frequently pairs it with other treatments to maximise results. For instance, after releasing the scar with subcision, he may follow with fractional laser resurfacing to improve the overall skin texture or injectable fillers to provide immediate volume support while new collagen develops. This synergistic strategy allows him to address both the structural tethering and the surface textural issues simultaneously, leading to outcomes that are far superior to any single treatment performed in isolation.
The Consultation: Personalising the Scar Revision Plan
Embarking on treatment begins with a comprehensive consultation. Dr. Sin Yong prioritises a detailed analysis of the patient’s scar history, skin type, and ultimate goals. Using magnification and good lighting, he maps out each scar, assessing its depth, mobility, and the nature of the tethering. This meticulous planning allows him to tailor the subcision procedure precisely, determining the depth of insertion and the specific technique required for each unique scar pattern. This personalised planning is crucial for achieving optimal, natural-looking results with minimal risk.
A Realistic Pathway to Smoother Skin
Dr. Sin Yong emphasises that while subcision is highly effective, managing expectations is key. Typically, a series of sessions spaced a month or two apart is needed to achieve significant improvement, as collagen remodelling is a gradual process. There may be some temporary bruising or swelling, but downtime is generally minimal. By offering a direct mechanical solution to the root cause of depressed scars, subcision performed by a skilled practitioner like Dr. Sin Yong provides a scientifically grounded and effective pathway for individuals in Singapore to finally achieve a smoother, more confident complexion.
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