Why subcision is different from every other acne scar treatment
Every other acne scar treatment works on the skin surface. Lasers resurface it. RF microneedling stimulates collagen beneath it. Chemical peels exfoliate it. All of these are valuable treatments — but for rolling and tethered acne scars, they address the wrong level of the problem.
Rolling acne scars are not a surface problem. They are caused by fibrous bands beneath the skin — strands of scar tissue that form between the dermis and the deeper subcutaneous layer, pulling the skin surface downward. No amount of collagen stimulation at the surface level can release a band that is anchored below it. The skin can become denser, smoother, and more refined — and the scar will still be there because the tether was never released.
Subcision is the only treatment that releases the tether directly. A blunt cannula is inserted beneath the scar and moved in a controlled fanning motion to break the fibrous bands. The scar is freed from the tissue pulling it downward. Sculptra is injected into the released space to prevent re-adhesion and stimulate long-term collagen remodeling. The result is structural — not cosmetic.
At Plump Medical Spa in Newport Beach, subcision is our signature acne scar treatment. It is the procedure we have invested the most clinical time in, the one that produces the most dramatic and consistent results, and the one that most patients in Orange County cannot find done well anywhere else.
The majority of acne scar patients who come to Plump have already had 3–6 sessions of RF microneedling elsewhere and feel they have plateaued. This is the most predictable pattern in acne scar medicine. RF microneedling is excellent for collagen stimulation — but it cannot release fibrous tethers. If you have had repeated surface treatments with limited improvement on rolling scars, you have untreated tethering beneath the skin. Subcision is what's missing.
See it in action — Dr. Mortazavi performing subcision
This reel shows the subcision technique performed by Dr. Mortazavi at Plump Medical Spa — the blunt cannula insertion, the fanning motion beneath the scar, and the immediate visible release of the tethered tissue.
Real patient results — before & after
These are real patients treated at Plump Medical Spa in Newport Beach with the subcision combination protocol. Results vary — but the consistency of improvement in rolling and tethered scars with this approach is what makes subcision our signature treatment.
The following two posts show the same patient — both sides of the face documented separately, showing the consistency of the result across the full treatment area.
The Plump Medical Spa combination protocol
Subcision alone is effective. Subcision combined with Sculptra and red light therapy is significantly more so — which is why we don't offer subcision in isolation. Every subcision session at Plump uses the full combination approach.
Why we add Sculptra
When a fibrous band is released, a void forms beneath the skin. Without filling that void, there is a risk that the band re-adheres as the tissue heals. Sculptra (poly-L-lactic acid) serves two functions: it physically occupies the released space to prevent re-adhesion, and it stimulates collagen production in the surrounding tissue over 3–6 months. The result is not just a released scar — it is a released scar with new collagen filling the space beneath it.
Why we add red light therapy
Red light at 630–660nm wavelength stimulates cellular repair and collagen synthesis. Applied immediately post-subcision, it accelerates the initial healing phase, reduces the inflammatory response, and supports the collagen remodeling that Sculptra initiates. It shortens the most uncomfortable part of recovery — the first 72 hours — and improves the overall result.
How the procedure works — step by step
Recovery timeline — what to expect
Who is a candidate?
Subcision is appropriate for most patients with rolling or tethered acne scars. It is safe for all skin tones including Fitzpatrick V and VI — a significant advantage over CO2 laser, which carries PIH risk in darker skin. It is not appropriate during active breakouts in the treatment area, and is not recommended for patients on isotretinoin or blood thinners without physician assessment.
A note for patients who've had RF microneedling: RF microneedling and subcision are not competing treatments — they address different levels of the problem. RF microneedling is excellent for the dermis. Subcision addresses the sub-dermal tethering that RF cannot reach. Many patients benefit from subcision first to release the tethers, followed by RF microneedling sessions to optimise the surface quality above.
Subcision is the procedure I am most confident about in acne scar medicine. When I see a rolling scar that softens under tension, I know exactly what is causing it and exactly how to address it. The combination of subcision, Sculptra, and red light is not a protocol we chose arbitrarily — it was developed from clinical experience and a clear understanding of what each component does and why. The results are consistent because the mechanism is sound.