Nobody88
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DIY SUBSCISION GUIDE
Disclaimer: This content is meant for entertainment purposes only and should not be replicated. Subcision should only be performed by appropriately trained medical professionals. Serious injury or disfigurement is possible.
Price: (the price estimate of 40-60 USD was taken from the cost of 6, 22g cannulas + 10% lidocaine cream+shipping, specialized needles or extra supplies may cost more) (feel free to DM for source on the cannulas lidocaine or just look online since these are not very difficult to get your hands on)
This thread should be read in combination with @bddcoper thread, since his covers many of these topics in more depth:
https://looksmax.org/threads/full-d...-important-notes-from-my-own-journey.1738853/
I tried to take these photos in bad lighting for my scars (spent like 5 minutes tilting my head in different directions) so I could make realistic progress photos. So if your scaring is worse than this (looks like this is everyday lighting) then it may take longer for you to see good results or your results might not be as good. I did my best to recreate the same angle and light but obviously they aren't perfect, I can say that looking at these photos that they pretty accurately represent my progress after 2 rounds of subcision (Photo 1 is before any treatment, Photo 2 is after 1 treatment, Photo 3 is after 2 treatments). I plan to do one more round of subcision combined with PDLLA (collagen stimulator), and in a few months a small amount of DIY filler under the scars (which I will make a thread about when I do it). Overall the results have been very good, in everyday lighting my scars are basically gone and it's only when the light catches the side of my face that they are still somewhat visible.
Permanent results (risk of retethering):
Results are permanent but while healing there is the risk of retethering. There are mixed opinions on whether filler can prevent this (in my opinion its effects on tethering are probably minimal unless you put in a ton of filler which would look silly). Regardless, some yt videos reference a study suggesting that you can have up to 50 percent change of retethering for grade 3 scars or worse, it isnt a 50% chance that there is no progress just that after cutting all of the fibrous bands 50% may retether (aka your permanent improvement might be half of your initial result if all bands are cut) (I found the study a long time ago on pubmed but I looked for a bit and couldn't find it).
How to know if your a good candidate (what types of scars does this work on):
Subscision is only really effective on tethered scars which are mostly rolling scars, but some boxcar scars can improve too (less indented but will still have the scar border). If you have icepick scars, lots of boxcar scars, or raised scars this treatment isnt for you, do your own research on what treatments would work with your specific scarring. Higher grades (3 and 4) have the most potential for improvement from subscision but can also take longer to see results.
Subcision on the temples or any area with thinner skin is more difficult, and doesn't provide as good results. Obviously if you have active acne or any other kind of skin condition DO NOT do this as you can make your scarring or acne worse.
Risks (this list is not exhaustive, please do your own research, please also see bddcoper's thread above for some additional risks and the risks of non cannulas and facial sagging):
Facial sagging is possible especially with broad movements, older skin, and devices like the taylor-liberator (basically a special kind of needle), from watching a ton of videos online I strongly believe that this is due to doctors making far too aggressive and large sweeping motions than necessary. Additionally many providers cut through facial ligaments (check bddcoper's guide) (know where these are and their depth if you are using any type of needle) which can also lead to sagging. Many patients are also older and don't have the same collagen response as younger patients. Despite the common training to use as few entry points as possible to save needles and reduce risks of infections. I used more entry points than the professionals if it required me to go through good skin to reach between scars (if clustered together small gaps are fine) as this will likely reduce your risk of sagging. When using needles or aggressively using the cannula, you can cut facial veins, arteries or nerves, which in severe cases could require you to go to the ER, be aware of facial anatomy and how deep your needle is (you should always be above these). If your face starts swelling rapidly after a movement you likely hit an artery so put pressure on the wound and if it is really bad got to the ER. Movements should always be controlled, you should know where your needle is, what depth, and the facial anatomy around your needle. If you combine this with filler there is also a risk of vascular occlusion.
Materials:
Lidocaine cream (ideally 10% or higher) (you can DM me for source) or another type of topical number is needed. I tried without it and it hurts too bad to concentrate.
Medical gloves are needed, ideally sterile gloves as you will need to be touching around your face.
Pilot hole needle: you will need a standard needle (most cannulas that are sold come with them, otherwise IV needles work decently with the plastic tube taken off) if it is the same size or a size larger (recommended) to create a pilot hole for your specialized needle or cannula.
The needle or cannula. This is by far the most important, needles cause more trauma, but can be more effective for deep scars, specialized needles like the Taylor Liberator or a Nokor needle are needed. My source was from a friend in a Dermatology office so I can’t help you with this one, but make sure the needles you are putting into your face are safe. The gauge of the Nokor should be around 18-22 gauge. Cannulas can also be effective and should be around 22-25G. Worst comes to worst I have heard of one case where a 20G IV needle (plastic tube taken off) was used to some success but I would highly recommend against this.
Cannula+ Pilot hole needle (I didnt use this brand but it was the only picture I could find of both):
Taylor Liberator:
Nokor:
Taylor Liberator:
Nokor:
Videos: Subcision: Does it cause facial sagging? | Dr Davin Lim Subcision for deep acne scars - lift up up ur scars immediately Is “Spacer Filler” Needed After Subcision Of Tethered Acne Scars? Subcision + Filler for Acne Scars
TIRED OF ACNE? GET RID OF IT WITH SUBCISION + FRACTORA | SKIN RESURFACING TREATMENT | Dr. Jason Emer (far too aggressive there is no need to be this rough to get results)
TIRED OF ACNE? GET RID OF IT WITH SUBCISION + FRACTORA | SKIN RESURFACING TREATMENT | Dr. Jason Emer (far too aggressive there is no need to be this rough to get results)
Procedure:
(Note: you will likely see some swelling that will make your scars look like they have disappeared, make sure you look for other indications that you released the tethers because otherwise after the swelling has gone down in a week or two your scars will be the same)
Setup:
1) Make sure you are in a somewhat sterile environment with lighting where you can see your scars but you can also see what you are doing (sometimes this requires multiple light sources and the ability to turn them on or off)
2) Place lidocaine or other numbing cream on the entire areas, and wait the recommended time (usually 30 min for it to be at full effect) (cling wrap on top of the cream helps with absorption)
3) Wipe cream off and Clean/prep skin (wash and then use some or of anti-septic (Isopropyl alcohol is ok but can dry and irritate skin),
(note some people like to mark off danger zones and the edges of the scars in case the swelling makes them difficult to see later)
Subscision:
1) Create a pilot hole at a shallow angle and Enter through normal skin at least 1cm away from the scar. Level out in the deep dermal/subdermal plane (different depth depending on facial location, do your own research) (should have minimal resistance other than scars, if it's too easy you might be too deep, and if its too difficult your likely too shallow)
2) Remove pilot needle (have cannula in hand ready to insert after removal), if you see significant bleeding you may need to use another spot.
3) Enter a specialized needle or cannula at the same angle and make sure you're in the deep dermal or subdermal plane (easy to move around in but meeting resistance with scars).
4) Make passes under the scar, you should feel light to medium resistance than a release (the example is cutting through a rubberband) you may also hear popping. Needles you may feel less of this than the cannula. Your goal is to release tethering until mobility improves (skin moves easier+is less indented and cannula moves easier under skin too).
5) After there is better mobility of the skin, less tethering, or it starts to look or feel excessive (swelling, pain, ect.) remove the needle and apply pressure with sterile gauze.
6) Check for rapidly expanding swelling (you hit an artery), normal color, normal cap refill (if there is a problem with any of these if it is severe you need to go to the ER.).
My personal approach + videos of the procedure:
From watching the yt videos above you can see that many practitioners are super aggressive, I don’t think that there is any need for this, when I meet resistance from the scars I slowly increase pressure until I cut through the bands. This results in less trauma and results that are likely just as good. From my videos you can see that the procedure takes me significantly longer because of this though. I also like to use more points of entry. Another tip is to have your cannula ready to enter your pilot hole immediately as you withdraw it because it will start to bleed (shouldn't be too bad) but it will make it more difficult to locate if you wait.
The video is not great qualify but you can see the rough the idea. I have a tremor which is why my hands are shaky, which means that this is even easier for someone without a tremor.
I edited it so you can see 1) creating the pilot hole 2) putting cannula in (I had a bit of trouble this time) 3) my method of resistance until the tether breaks and 4) how much easier the cannula and the skin moves after a few passes. (I'm going to put a reminder here that this procedure can cause serious injury and is dangerous if performed on yourself/not by a medical professional)
Post-care: Pressure/ice if you have swelling and avoid exercise for a couple of days. Sometimes you can get bruising like you can see in the photo of me after my first subcision so keep that in mind.
Filler: I wouldn’t recommend combining it with subcision if your DIYing both since the swelling and trauma can make it difficult to place correctly, and it has a high migration risk due to being low g and due to the swelling. Basically after you are done snapping the bands (but while your cannula is still under the skin,) you want to put a VERY SMALL amount of low G filler (medium can work too but is more difficult and less forgiving), until you see the depression raise (trying to get it perfectly flat is dangerous as you do not want to overfill so I would recommend underfilling slighting and revisiting if you need it). I would highly recommend a cannula rather than a needle to reduce the risk of vascular occlusion as well as to help with placement (dermis or deep dermis). Make sure you know what you are doing with filler as it can be dangerous and areas like the temples, forehead and other areas are significantly more dangerous to inject in.
Future Threads: If anyone would like to be tagged in any of these lmk.
1) DIY acne scar filler,
2) Genioplasty guide+ my 8.5 mm advancement (results here),
3) Results from DIY jaw and zygo filler (Better guides already exist so I'm not going to make one),
4) if anyone is interested I will make a thread on how to make food for girls+ a good recipe for handmade italian Gnocchi with marinara sauce and how to play/write songs for the piano (which is a pretty decent hobby that girls tend to like).
@o_Owtf , @Sayori , @Orka, @chudpiller, @soalone
