Subcision is a minor in-office procedure in which a fine needle or blunt cannula is inserted beneath a rolling scar to release the fibrous bands tethering it downward. The area is numbed first, so most patients report pressure rather than pain. Expect bruising for roughly one to two weeks — it's the most visible downtime of any treatment we offer for scars, and also the only one that addresses tethering directly.

They solve different problems, and many patients need both. Subcision releases rolling scars pulled down from beneath; CO₂ laser resurfaces textured, boxcar, and ice-pick scarring from above. Resurfacing a tethered scar won't lift it, and releasing a tether won't smooth surface texture. Dr. Kotecha maps your scars first, then sequences the treatments with healing time between.

Most patients experience redness and mild peeling for five to ten days, depending on the depth of resurfacing selected. Applying exosomes immediately after treatment can support a faster, more comfortable recovery. Initial improvement appears once the skin heals, and collagen production continues for months afterward — so your skin keeps improving well past the visible healing period.

Yes, with the right device and the right settings. Deeper skin tones carry a genuine risk of post-inflammatory hyperpigmentation from aggressive lasers, which is why Dr. Kotecha has invested specifically in technologies safe across Fitzpatrick I–VI. Aerolase NeoClear® and Sylfirm X are frequently chosen for deeper tones, and pre-treatment priming plus conservative depth settings further reduce risk. This is a conversation to have in person.

Most patients need two to four sessions for optimal results, though this varies with scar severity and the combination used. Subcision often takes one to three sessions spaced four to six weeks apart. RF microneedling typically runs three to four sessions. CO₂ may be a single deeper pass or a staged series.

Collagen-building treatments produce durable improvement, and Bellafill® correction can last up to five years. Results from subcision are long-lasting once the bands are released and prevented from re-adhering. Ongoing skin health, sun protection, and occasional maintenance sessions preserve your outcome.

Honestly, no — scarring is meaningfully improved rather than erased. Most patients see substantial smoothing and evening of texture and tone with a well-sequenced plan. We'd rather set that expectation clearly at the start than oversell an outcome. Combination therapy consistently outperforms any single treatment.

Active acne should be well controlled before scar revision begins. Treating scars while breakouts are ongoing creates new scarring and complicates healing. If you're still breaking out, we'll address that first — sometimes with Aerolase, which treats active acne and scarring together.

Yes, and they usually should be. Subcision pairs with PRF or Bellafill®, CO₂ pairs with exosomes, and microneedling pairs with PRP. What matters is sequencing and spacing — combining treatments carelessly in one visit increases risk without improving results.