• Subcision UK

    Acne Scarring Treatment

INTRODUCTION

Dr Hussein performs a technique known as: Full-Field subcision under tumescent anaesthesia (Taylor Liberator Technique)

He acquired the technique from Dr Mark Taylor in Salt Lake City USA. Dr Mark Taylor first developed this technique. Currently Dr Hussein is the only doctor in the UK capable of offering this technique.

Patient Suitability

Dr Hussein will have assessed your acne scarring type at consultation. If he feels subcision may be appropriate then he will discuss this technique with you. This tends to be suitable where there are scars that are tethered to deeper layers below the skin. This tethering requires separation using a procedure called subcision. Subcising tethered acne scars allows the depressed scars to ‘pop out’ and the skin will as a result appear less dented.

View before and after photos.

PROCEDURE DETAILS

Male clients must shave a day before the procedure. Any beards must be removed to allow good visibility of the area to be treated. Hair must be tied back and headbands applied.

Make up must be removed thoroughly.

The skin will be prepared for surgery with Chlorhexidine.

The entire procedure will be performed with the patient lying flat. If there are issues with lying flat for approximately 1 hour then Dr Hussein must be notified pre procedure.

A dermal marker will then be used to mark the acne scars. This is very important as once high- volume tumescent anaesthesia is administered the subsequent tissue deformation can make landmarks difficult to appreciate.

Individual acne scars can also be marked under tangential illumination and it is also useful to delineate the gross affected area. This facilitates a more targeted subcision without the need to unnecessarily subcise unmarked areas which could result in needless risk to various important structures.

The tumescent solution will now be administered using the pump, giving set and a 22G blunt cannula. As the recommended pumps have a high flow rate rapid infiltration can be achieved. This is crucial for the technique. Rapid infiltration allows the tissues of the subcutis to become turgid with tumescent mix. This separates the underside of the dermis away from important neurovascular structures. Creating this gap dramatically increases the safety of subcision and reduces the risk of nerve damage and vessel disruption/haematoma. Both sides of the face are infiltrated. There will be a 20-minute wait following initial tumescent administration after which a ‘top up’ of tumescent will be given.

A small puncture incision is made with No.11 scalpel blade and the subcision probe can be passed under the skin with relative ease. The forked tip allows for scar bands to be directed towards the blade element of the probe. During passage of the probe under the skin elements of resistance will be encountered. The patient should not feel any discomfort but will feel movement within their cheeks.

Following completion of the subcision the probes will be removed. The entry site is of a small enough diameter (4mm) and not under significant tension hence a suture (stitch) is unnecessary.

The skin will be cleaned and dressings applied over the entry site wounds. The patient will be then asked to apply pressure using gauze pads over the treated area for a further 30-minute period. The patient will be observed for a total of 1 hour after the procedure. If all is well, the patient will be discharged and appropriate follow-up arranged.

BEFORE & AFTER PHOTOS

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VIDEO

Warning – contains footage of real procedure

POTENTIAL COMPLICATIONS

Surgical Subcision for Scars

Please view below a copy of the Consent Form that you would be required to sign before undergoing this treatment:

What is surgical subcision?

This is a surgical procedure that is designed to free the tethering fibrous scar bands that pull scars inwards and cause indentation and dimpling of the skin. Subcision is performed with a small dissecting probe that is directed by the surgeon toward the underside of the deeper layer of skin (dermis) to release the scar bands. The probe is introduced into this layer by a small linear incision on the facial skin that is 5mm in size. This should heal spontaneously with minimal scarring. The procedure can be performed on almost all areas of the face (excluding the nose and area around the eye) that are dimpled and depressed by scar bands underneath the skin.

What are the benefits of subcision?

Subcision releases scar bands allowing indented skin to be released and gives skin a smoother appearance.

How is the procedure performed?

Subcision is performed using a dilute mixture of anaesthetic that is injected under the area to be treated. The probe is introduced into the skin and slides along the bottom of the dermis cutting through scar bands that connect the skin to the deeper tissues below.

What are the risks of subcision?

The risks of subcision are similar to other facial surgical procedures and include:

  1. Bleeding
  2. Haematoma (collection of blood under the skin)
  3. Infection
  4. Scarring
  5. Temporary or permanent nerve damage
  6. Swelling
  7. Abnormal skin colour
  8. Failure to achieve the desired result

Informed consent:

I understand the subcision procedure and all of my questions regarding benefits, risks, costs and alternative treatment including no treatment have been answered. I hereby give consent for the subcision procedure to be performed on myself (or legal dependent).

Further Information

Nerve Damage

Nerve damage is a potential consequence of subcision treatment. This type of nerve damage has two types of consequence. The first is sensory disturbance to the skin with patches of altered sensation or numb patches.

The second and more severe consequence is disruption to the facial nerve resulting in partial or complete paralysis of one side of the face.

Although the chances of this are quite low due to the level in the skin at which the subcision takes place it is a foreseeable complication of the procedure.

The numbing injection can temporarily reduce movements and mimic paralysis but this movement will return within 24hrs as the numbing injections wear off.

Bleeding

Subcision will inevitably cause some damage to perforator vessels that supply the skin with blood. Bleeding is minimized with the use of a special anaesthetic mix that reduces bleeding from disrupted vessels. It is however possible for a haematoma (clot) to form below the cheek. Small amounts of clot are acceptable and will result in visible bruising. In the worse case scenario a large clot causing pressure may require surgical drainage.

You will be monitored for a period of 1-2 hours post procedure before being able to leave the clinic.

Infection

Your Doctor may give you antibiotic tablets for a period of a week after the procedure to minimize any infection risk. Developing infection will manifest as painful swelling and heat in the affected area after the treatment. If worsening pain and swelling is encountered after the treatment contact Dr Hussein immediately.

AFTERCARE

The tumescent anaesthesia used in full field Taylor Liberator subcision causes swelling of the face. This swelling has largely resolved 24-48 hours after the procedure. Facial movements should return slowly following the procedure. A full range of facial motion should be seen on the morning after the procedure. If this is not the case make sure you contact Dr Hussein.

The following precautions should be taken after the procedure:

  • No vigorous exercise for 48 hours after the procedure
  • Avoid any blood thinning medication such as ibuprofen and aspirin for 48hrs post procedure.
  • Avoid hot (temperature hot) food and drink for the first 24 hours post procedure.
  • Keep the dressings on the entry site wounds on for 48 hours. Change if necessary.
  • Do not put pressure, tension or vigorously wash the face until 48hrs post procedure.

COST

  • Subcision – £1,500 per treatment session

GOOGLE REVIEWS

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Miss L
Miss L
21:20 30 Jul 20
I had fully ablative co2 laser resurfacing 15th February this year (it is now July) and it was quite an experience!... This is a long one which will hopefully be helpful to anyone considering having it done who would like some insight. I will start by saying that I'm probably not the most obvious candidate for it as I'm only 30 and have been fortunate enough not to suffer acne scarring however I am a skin obsessive and perfectionist so I see a thousand flaws and I had it done as I wanted to get rid of some of the fine lines that had taken up residence over the last 5 years or so as well as other imperfections. The procedure itself wasn't painful (at least not most of the time) and Dr H was very reassuring however it does leave you feeling rather in shock afterwards I found, so if you can, have someone waiting for you after. I was prepared for pain in the immediate recovery days what I wasn't prepared for was how little I would be able to see due to the swelling up around my eyes (audio books are your friend at this point people! Also plenty of painkillers and food that you can eat without having to open your mouth too wide because that will hurt too.)I had a week off from work and then I had to go back and well looking at me was definitely pretty shocking - no longer hideous like I had been (there is a definite hideous monster stage of recover, no point sugar coating it) but pretty darn shocking. I had a lot of odd looks and as a teacher I gave my poor kids a bit of a shock but thankfully kids are super accepting. Every time I caught a glance of myself in the mirror though I'd be like "wow the kids are amazing!" they treated me just like normal after the initial morning of shock wore off and honestly I looked pretty awful for a while. Kids are way better at that stuff than adults. You just have to roll with it and concentrate on making sure you're doing everything right to help your skin recover. I didn't rush to put make-up back on or anything because honestly why potentially mess something so major up by not just waiting a little while longer. I did unfortunately get an infection around my eyes which meant they took longer to heal overall but Dr H soon got the infection itself cleared up and he checked the selfies daily. The recovery can be hard, I expect some people heal a lot more quickly than I do but I'm not a fast healer and it isn't easy to constantly have to put yourself out there not looking like yourself. It was at least month before I started feeling like my outside reflected my inside again and it can make various aspects of life difficult. Shortly before lockdown happened in the last week of schools being open I was wearing very light make-up again and looking passably normal but although probably not noticeable to most people I was pinker in overall tone and that takes a long time to fade. I was finally feeling attractive again though - yay! I think my skin appreciated lockdown and having more time of zero commute/pollution/little make-up as it gave it more recovery time and I now look totally normal. Well I say normal...I look better! The little lines around my eyes - gone! My cheeks - plumper! Gotta love that collagen. My mum says my cheeks remind her more of 19 year old me. It has also slightly softened the frown between my eyebrows (that thing is a curse) It hasn't totally perfected my skin but it has done a darn good job of all but the most problematic area of it. My friends say I look really good and I did not look bad before! It is quite fascinating because it is basically impossible for someone to put their finger on exactly what is different but something subtle is. I think if you had more skin irregularities or older skin you would probably see more dramatic results but it would still be very natural looking. I would have it or something similar done again in another 10 years or when I felt it needed doing but I urge you do plan enough down time! Was it worth it? Yes..but I'm not rushing to go through that recovery again ;)I hope this has been helpful 🙂 Thanks Dr Hussein 🙂read more
Siobhan Todd
Siobhan Todd
18:27 30 Jul 20
5 star results and 5 star service. I felt at ease in Dr H and his staff’s hands throughout my co2 laser resurfacing... treatment and after treatment, Dr has been on hand with any questions I’ve had and regular updates throughout my recovery. I received co2 laser mainly for acne scarring & marks and have noticed a dramatic difference in texture already, I feel like I have new baby skin 🙂read more
Laura Robinson
Laura Robinson
17:21 19 Jul 20
I am literally over the moon with the results of my fully ablative CO2 laser treatment. I have spent years researching... for the perfect Doctor and correct procedure to help reduce my acne scarring, I finally decided on Dr Asif and travelled from Liverpool to London for the treatment. Dr Asif and his team are so professional and supportive both during the procedure and the following weeks. I would say my skin is looking 80/90% better than before. Thank you so much Dr Asif, you're the best.read more
Anne Swan
Anne Swan
19:03 14 Jul 20
I am absolutely delighted with the results of my CO2 laser treatment. It was a big decision to have it done but Dr.... Hussein and his team could not have been more professional, more helpful or more supportive - both during the procedure and in the weeks following it. The improvements are considerable but look totally natural and I feel so much more confident. Thank You!read more
Aura Bo
Aura Bo
18:00 10 Jul 20
I had tailored liberator subcision with Dr Hussein, he was so friendly, knowledgeable and professional! The procedure... was not painful at all, you'll be under local anaesthetic, and even after that you feel 0 pain! The recovery was super quick just 1 day. You can see results the day after, I can see a major improvement in my tethered scars and I am also having done in 1 month the Fully Ablative Laser. If you have acne scars, trust Dr Hussein, he is honestly the best specialist out there! I cannot thank him enough, he brought so much confidence in my life!! 5 *****read more
PKo99 MD
PKo99 MD
11:26 07 Jul 20
I reached out to Dr. Hussein, from the US, to discuss ablative laser resurfacing and to discuss his approach with acne... scar cases. He couldn’t have been more friendly and attentive during these discussions. He clearly understands parameter control and was willing to share his insights which is very appreciated. Happy to have met him and would recommend him to anyone in need of resurfacing. You will be in good hands.read more
Sandra Gil
Sandra Gil
14:39 04 Jul 20
I had the CO 2 laser with Dr. Asif Hussein and the results are amazing eventhoug I was very apprehensive about the... whole procesure his professional team kept me at ease. Dr. Asif shows his passion and guide me throug the whole journey. I'm very happy a 100% recomend..read more
Bianca B
Bianca B
15:53 03 Jul 20
I was so impressed with Dr Hussein and the entire team. Very happy and pleased with the visible results after my laser... treatment. Amazing staff and an even more amazing service!read more
Teresa Ryan
Teresa Ryan
11:53 03 Jul 20
Dr H was recommended to me as in the past I had a bad experience with a Dermatologist sometime ago. I could not... recommend Dr H more as from the first consultation Dr H was honest and straight forward about the treatment I needed for acne scarring. Dr H recommended Subcision first followed by C02 Laser. Dr H fully explained the reason for the Subcision and i am glad I went for it. I have seen a significant difference in the scarring with the Subcision alone. I have now followed this up with the C02 laser and although I am still in the healing process, I am looking forward to seeing the results. Throughout this, Dr H has been in contact, and taking me step by step through the process. On both treatments, Dr H was very reassuring and informed me of what he was doing and when, which relieved some of the anxiety. I also have to mention Lulia, who has been great again through both treatments Both make a great team.read more
Iria Behbahani Ortola
Iria Behbahani Ortola
09:42 18 Mar 20
I am very happy with the result!I had very large pores and sun damage on my skin, I had halo laser but it was a light... laser for the size of my pores so we attempted a mild Co2 laser, today is day 11 and I can't be happier with the results, the large pores have reduced a lot! My skin looks younger, healthier, still a bit red but that will settle soon.I have definitely achieve what I wanted I am not going to wear make up foundation for a while 😊. Dr H has been there for me every time I had a question, daily since the first day giving me advice and looking after me. It was the best money investment I've done on my skin. Also mention Iulia, she has been incredible taking care of me while I had the treatment as I had to go on my own to the clinic, reassuring me and making sure I was fine. I know how important is this as I am a nurse myself, they both made me feel like at home. Thank you all! 😘😘read more
Sarah Fox
Sarah Fox
12:51 08 Mar 20
I was recommended Dr Hussein by a friend and have been having anti-aging treatments for a couple of years. I am always... very happy with the results and find him highly skilled, reassuring and friendly. He offers wise skin advice and his treatments are targeted at exactly the areas that need work, non invasive & quick procedures. His results are subtle and natural which is exactly what I want to achieve. I highly recommend Dr Asif Hussein.read more
Scan Services
Scan Services
17:31 04 Mar 20
A few weeks ago I have done CO2 laser (fully ablative laser resurfacing) with Dr H and I can highly recommend him. I... truly like the way how he keeps in touch with patients, checking on you, taking care of you.He definitely knows what he does! I can already see big improvement on my skin texture even though I know my skin still needs loads of time to fully settle so the improvement will continue.Thank youread more
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