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2026.10.18
Subscription: Criteria for Avoiding Failure and Realistic Expectations | A Guide to Dealing with Pitted Skin
As an Assistant Professor, Associate Ward Director, and Chief of Dermatopathology at the university hospital dermatology department, I deepened my expertise through academic presentations and paper publications both domestically and internationally. I have handled a wide range of treatments, from birthmark therapy in children to adult pigmentation concerns, utilizing various lasers and injection therapies, while also contributing to community healthcare. Through encountering numerous cases, I strongly felt the potential and necessity of aesthetic medicine, resolving to pursue further expertise. Building upon my solid dermatological knowledge and meticulous diagnostic skills, I value treatments that gently support each individual's skin while bringing out its inherent beauty.
When considering subcision as an option for treating indented skin, it’s natural to feel anxious about what might happen if it doesn’t work out.
In reality, many feelings that things “aren’t going well” stem from a mismatch in adaptation, a gap between reality and expectations, or misunderstandings regarding care or the course of events.
In this article, we’ve elegantly and honestly summarized the criteria for avoiding subscription failures and a realistic solution.
We won’t rush to a conclusion; instead, we’ll lay out a path that allows you to make a choice that fits your lifestyle and aspirations.
[Doctor’s Note]
Subcision is a treatment that releases fibrous adhesions pulling on the indentations caused by acne scars from within the skin.
However, it is not suitable for all types of indentations. While it can be effective for indentations with significant subcutaneous adhesions, it may be better to combine this treatment with other therapies for deep, small, pinpoint indentations.
In addition, swelling, bruising, and temporary unevenness may occur after the procedure.
The key is to accurately assess the shape and depth of the indentation and develop a treatment plan after understanding the expected degree of improvement and the associated risks.
What Is Subscription? Technical Terms Explained Simply
Subcision is a procedure based on the concept of loosening the fibrous adhesions that are pulling down the indentations beneath the skin, thereby lifting the indentations.
In other words, this approach involves reducing the appearance of shadows by releasing internal tension. Results, discomfort, and downtime vary from person to person, and it is common to undergo multiple sessions to gradually achieve the desired results.
Subscription: When Do People Tend to Feel It's a Failure?
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The change is smaller than I expected / I thought it would be over in one go
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I'm concerned about asymmetry or new unevenness (including effects from swelling or bruising)
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I feel like the bruising and discoloration are lingering
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Temporary swelling or stiffness (a lump-like sensation) may occur
These range from reactions that may occur during the course of treatment to a failure to properly assess the patient's response.
Since the impression can vary greatly depending on when the progress photos were taken and how the light is directed, it’s important not to jump to the conclusion that it’s a “failure” too soon.
Criteria for Avoiding Failure
1. Determining Suitability
While shallow indentations that roll around are well-suited for this method, it may be more practical to combine it with other techniques when dealing with deep, small, pinpoint indentations.
Let's develop a treatment plan after assessing the underlying factors, such as the affected area, skin thickness, and tendency for acne to recur.
2. Adjusting the Expected Value
A design that involves making adjustments gradually over several sessions may make it easier to strike a balance between the final result and downtime than one that aims for a dramatic transformation in a single session.
If necessary, we will also consider the option of combining this treatment with procedures to refine the skin’s texture or injectable treatments, scheduling them at different times.
3. Tracking Downtime
Swelling and bruising may last from a few days to about two weeks, though this varies from person to person.
Avoid scheduling these activities around important events, and plan your schedule to include managing your sleep, meals, alcohol consumption, and exercise.
4. Sharing Postoperative Care Information
Guidelines regarding daily care—such as keeping the area cool and clean and preventing reattachment—vary from clinic to clinic.
The surest way to achieve stability is to follow the instructions exactly as described, without adding or omitting steps based on your own judgment.
Who This Is For / Who Should Consider It Carefully
Suitable for
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A type in which adhesions appear to be involved—for example, a depression that moves when pressed or a shadow whose shape changes from day to day
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People who are open to undergoing treatment in several sessions and follow-up visits, and who are willing to accept gradual improvement
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People who can set aside time for rest and consistently practice thorough self-care
People who want to consider this carefully
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People with a strong tendency to bleed, a predisposition to hyperpigmentation, or restrictions regarding their medication regimen
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People who want only a significant change in one go and are reluctant to accept multiple proposals
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People who have no time to spare during downtime, such as those with a series of important upcoming events
Potential Risks and How to Approach Them
These include swelling, pain, bruising, temporary unevenness, and firmness; in rare cases, infection, hyperpigmentation, and excessive fibrosis may also occur.
Results vary depending on the treatment area, individual constitution, and lifestyle. It’s reassuring when thorough counseling, follow-up care, and a treatment plan for when necessary are discussed in advance.
How to Interpret "Before & After" Images and Tips for Comparing Them
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Shooting Conditions: The shadow cast by a dent changes significantly depending on the intensity, angle, and distance of the light.
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Time Period: Vision differs immediately after, at 1 month, and at 3 months. Check the timing.
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Whether Used in Combination: Check to see if any other procedures are scheduled for the same time.
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Differences in Skin Type: The reaction varies depending on skin thickness and sebum levels.
“Before & After” serves as a "guide for direction." Thinking about it in terms of your own type of indentation and schedule helps alleviate anxiety about subsidence failure.
Frequently Asked Questions
When will I start to see results?
The contours will begin to show around the 2nd to 4th week, once the swelling has subsided, and the results will be easier to assess after about 3 months. Results may vary from person to person.
How many times will I need to do this?
It depends on the depth and extent of the indentation. While some people are satisfied after just one session, we may recommend two, three, or more sessions.
How long is the downtime?
Swelling and bruising typically last from a few days to about two weeks. Follow your doctor’s instructions regarding when to resume wearing makeup and exercising.
Can this treatment be combined with other treatments?
Sometimes treatments are scheduled at different times. The best approach is to plan them carefully while monitoring the condition of your skin.
Will it come back?
Your appearance may vary depending on your lifestyle and skin type. In the long term, a skincare routine and UV protection can also help maintain your results.
Creating an Environment That Encourages Open Communication
Subcision isn't a “one-size-fits-all” approach. Sharing details about the type of indentation, your daily routine, and your priorities (speed, natural results, downtime) will help lead to a plan you can feel confident about.
First, try putting your worries and hopes into words just as they are. If you’d like to know if this is right for you, please feel free to contact us for a consultation.
Summary
To avoid regret with subcision, it’s important to determine whether the procedure is suitable for your acne scars and to set realistic goals for improvement.
Depending on the shape and depth of the indentation, subcision alone may not provide sufficient improvement, so it may be combined with other treatments, such as fractional laser therapy.
Be sure to understand the risks, such as post-operative swelling and bruising, the required downtime, and the possibility of needing multiple treatments.
Rather than aiming for perfect skin in a single session, choosing treatments in stages that are tailored to your skin's condition will lead to results you'll be satisfied with.
