LAM FACIAL PLASTICS

Hi Dr. Lam-

There is a new procedure with clinical trial information just released on the web a few months ago on subcision (subcutaneous incision) followed by suction. Following the third day of subcision, a repeated suctioning is performed. However, I am unable to produce any information on exactly HOW the suctioning is done.

These are the links on subcision-suction for depressed acne scars I was able to come across on a google search, some peer-reviewed and background information on case studies:

http://onlinelibrary.wiley.com/doi/10.1 ... x/abstract

http://www.skinandallergynews.com/news/ ... de783.html

THIS ONE IS FROM PUB MED:

http://www.ncbi.nlm.nih.gov/pubmed/20553364

http://www.medwire-news.md/66/87965/Der ... scars.html

http://www.skincaretreated.com/journal- ... um=twitter

Although I am unsure on how the suctioning is performed (e.g. instruments, method), it would make theoretical sense that this would work better because you are giving more time for lost tissue to rebuild within the recess by keeping the skin elevated for longer period of time. Also, wondering if this could be combined with silicone or fractional laser resurfacing (e.g. DEEP FX, WHICH i'M CURRENTLY TRYING FOR ROLLING SCARS) for dramatic improvement. The studies indicate very good results, and I have asked several other US dermatologists about it who could provide no information.

hi,
sorry i had to delete references to other doctors' names here since this site is not intended to promote or disparage other providers. i would say there are always new things on the horizon, and i am always open to hearing about new methods. however, this method does not make too much sense to me logically but anything is certainly possible.

Hi Dr Lam,

May you explain why the logic of suction in conjunction with subcision does not make sense?

i honestly do not know why it does make sense? why would suctioning and subcision work at all? i think subcision alone is already not very effective. how would adding suction help? i am always open to thinking of new ways to see things but right now i remain humbly skeptical.
best,
sml

I see that you dont think it sounds logical because you dont believe subcision works. However assuming that you do think subcision works, would you agree that suctioning in conjunction will increase efficacy?

Subcision breaks apart the fibrous bands that connect the scar to the tissue. The problem with subcision is that after x amount of days, the fibrous bands attaches the scar back the tissue which results in re-depression of scars. The suctioning method delays the fibrous bands from connecting back to the tissue early.

Do you perform subcision by the way?

i cannot answer theoretical questions because they would not be based on experience. i would say that logically what you are asking does not make intuitive sense to me. a subcision does not free up fragments of tissue that can be suctioned out. plus even if it did, those fragments are just debris that would not lead to readhesion. readhesion is just your body reattaching from one tissue to another. now if you subcised and injected some restylane so that the two opposing areas do not touch that would then have at least intuitive appeal to me, much more so than suctioning which at face value sounds like complete nonsense. do i perform subcision? yes. but rarely. i use it in rare cases when i find nothing else worked as well as i thought but as a first line i just find that it so rarely works well that i don't bother in most cases.