Subscision is ideal for deep tethered scars, while punch excision is used for very deep enlarged acne pores and scars.

Procedures such as subscision and punch excision are performed by Specialists to treat certain forms of acne scarring. Subscision is ideal for deep tethered scars, while punch excision is used for very deep enlarged acne pores and scars.

Surgical techniques are often combined with Fractional Laser and TCA peels as part of the Synergy Program for acne scar revision.


  • Subscision and punch excision are surgical methods of acne scar removal
  • Subscision is an excellent method of treating tethered, or puckered acne scars
  • Punch excision is used if acne scars are in the form of deep open pores such as enlarged pores and ice-pick scars
  • We often combine surgical methods with lasers as part of our Synergy Program for acne scars


Mixed Acne Scars

Rolling & Depressed Acne Scars

Ice Pick Scars

Subscision is a specialised surgical technique used to release tethered bound down and pucked acne scars. This type of acne scarring causes a depression in the skin, and is due to abnormal attachment of collagen fibres to the skin’s dermal layers. Subscision breaks down the collagen fibres that anchor the scar. Over several procedures, the acne scar lifts upwards. Specialists perform this procedure with a special needle to free up the scar tissue.

Subscision is often combined with laser procedures and fractional resurfacing as part of our Synergy Approach for acne scar revision.

Punch excision and elevation is ideal for enlarged open pores, and very large deep ice pick scars. This is a surgical procedure that removes the scars with a surgical instrument called a punch biopsy. Most cases will require either a 1 or 2 mm defect. Stitches are needed for this procedure. The majority of patients will require laser resurfacing to even out the skin’s texture 2-4 months after punch procedures.

Acne scar subscision and excision takes several minutes to perform. The first step is identifying scars that will respond best to this procedure. Tethered, puckered and bound down acne scars respond best to subscision, whilst deep wide pick scars and enlarged pores respond best to punch excision.

Once scars are identified and mapped, we numb the area with a tiny injection prior the procedure. Both techniques require special skill to perform correctly. Once the procedure is complete, a dressing is worn for 12-24 hours after surgery.

Subscision, TCA CROSS and Excision of scars. Dr Davin S. Lim, procedure as part of the Synergy Program for scar revision.


Recovery time varies from 2-5 days. With subscision there will be bruising for several days after the procedure. With punch excision, there will be sutures for 5 days post revision.

No. This procedure is surprisingly pain free. We always use a local anaesthetic injection prior to any acne scar surgery. Pain is minimal post procedure.

Absolutely. In fact surgery for acne scars form an integral aspect of the Synergy Program. We often combine subscision with procedures such as TCA Cross, fractional resurfacing- Fraxel, laser resurfacing and RadioFrequency to deliver the best possible results.

At the Acne Specialist Clinics we only utilize the most up to date technology and procedures performed by Specialist Dermatologists. An assessment is the very first step in scar revision. Identifying and mapping your scars will enable us to tailor your scar revision program.

Surgical methods of acne scar removal are partially covered under Medicare. Costing will depend on the number of scars revised and the complexity of the procedure. A scar assessment will give an accurate quote for any scar revision program.

Dr Davin S. Lim
Acne Specialist Clinics
Westside Laser Dermatology

Surgical techniques such as subscision forms an integral part of acne scar revision. Puckered, anchored, tethered and bound down scars lie very deep in the dermal layers of skin- out of reach of even the most powerful lasers. Subscision uses a special needle that runs parallel to the skin’s surface and breaks down the collagen. The procedure, if performed correctly will result in an instantaneous improvement in the scar. I usually perform 2-3 subscision procedures, spaced 4-8 weeks apart.

Subscision, along with surgical techniques such as punch elevation, punch excision, and dermal grafting are combined with scar revision procedures such as TCA CROSS, Fractional laser resurfacing, CO2 and Erbium laser, RadioFrequency and vascular lasers to produce the best possible outcome for acne scar patients. This is the basis of the Synergy Program for acne scars.