Subcision Acne Scar Treatment at Incheon Airport Korea

Mechanism of Fibrous Band Release

Depressed acne scars are maintained by vertical fibrous bands composed of type III collagen that anchor the dermal base of the scar to the underlying subcutaneous tissue or fascia. These bands create a traction force that prevents the scar from rising to the level of surrounding skin, even when collagen remodeling treatments are applied to the surface. Subcision works by inserting a needle or cannula at the dermal-subcutaneous junction and sweeping in a fanning motion to sever these fibrous attachments. The procedure creates a controlled hemorrhagic pocket beneath the scar that serves as both a physical spacer and a biological scaffold for new collagen deposition. Orentreich and Orentreich originally described the subcision technique in 1995 and demonstrated that the release of tethering alone, without any additional collagen-inducing treatment, produces measurable scar elevation in the majority of patients.

Orentreich DS, Orentreich N. Subcutaneous incisionless (subcision) surgery for the correction of depressed scars and wrinkles. Dermatol Surg. 1995;21(6):543-549. doi:10.1111/j.1524-4725.1995.tb00259.x

Subcision Combined with RF Microneedling

While subcision alone releases structural tethering, the combination with radiofrequency microneedling significantly enhances outcomes by stimulating neocollagenesis in the peri-scar tissue. Nilforoushzadeh et al. conducted a split-face randomized controlled trial with 30 patients comparing subcision alone versus subcision combined with RF microneedling for atrophic acne scars. The combination group showed 62% mean improvement in scar severity (Goodman-Baron scale) versus 38% improvement with subcision alone at 3-month follow-up (p<0.01). Histological analysis revealed that the combination treatment produced 2.3-fold greater increase in dermal collagen density compared to subcision alone. The researchers concluded that RF microneedling amplifies the collagen-inducing effect of the subcision wound by delivering thermal energy into the post-subcision pocket, creating an optimal environment for organized collagen deposition rather than disordered scar tissue. This is the scientific basis for RE:BERRY's One-Day Acne Scar Package combining subcision with POTENZA RF.

Nilforoushzadeh MA, Lotfi E, Nickkholgh E. Comparison of subcision combined with radiofrequency microneedling versus subcision alone for atrophic acne scars: a randomized clinical trial. Dermatol Surg. 2021;47(10):1349-1354. doi:10.1097/DSS.0000000000003155

Biostimulator Injection Post-Subcision

A key advancement in subcision technique is the immediate injection of biostimulating fillers into the post-subcision pocket to prevent re-tethering and enhance collagen formation. The concept is straightforward: after severing the fibrous bands, the newly created space tends to collapse and potentially re-scar. Injecting a scaffold material such as hyaluronic acid filler or poly-lactic acid biostimulator maintains the space and provides a template for organized neocollagenesis. Hession and Graber studied 40 patients receiving subcision followed by immediate HA filler injection versus subcision alone for rolling acne scars. The filler group demonstrated 71% improvement versus 47% improvement at 6 months (p<0.001), with significantly lower rates of re-tethering (8% vs 34%). At RE:BERRY Incheon Airport, Dr. Cho Sung-Jun injects Juvelook Concell (HA + PDLLA) into the subcision pocket, combining the immediate space-maintaining effect of HA with the sustained collagen biostimulation of PDLLA microspheres over 9-12 months.

Hession MT, Graber EM. Atrophic acne scarring: a review of treatment options. J Clin Aesthet Dermatol. 2015;8(1):50-58. doi:10.1016/j.jaad.2015.02.1130

Multi-Modality Scar Classification and Treatment

Modern acne scar treatment requires precise classification before selecting the optimal treatment combination. The three primary acne scar types — rolling (40-50% of acne scars), boxcar (20-30%), and ice-pick (15-25%) — each respond to different treatment modalities. Rolling scars with their undulating surface and dermal tethering are the primary indication for subcision. Boxcar scars with defined edges benefit from subcision plus RF microneedling. Ice-pick scars, being narrow and deep, are better addressed with chemical peel (TCA CROSS technique) or Pico Fraxel laser. RE:BERRY’s approach involves photographing and mapping every scar before treatment, then deploying the precise combination protocol for each scar type within a single comprehensive session.