How Does Rejuran Scar Subcision Work? Everything You Need to Know
Subcision has been used for depressed acne scarring for decades. Rejuran scar subcision takes that same mechanical approach and adds a polynucleotide injection in the same session to support what happens underneath the skin after the fibrous bands are released. Here’s exactly how it works, which scars it suits, and what the treatment process actually looks like at SDL Australia.
TL;DR: Rejuran scar subcision is a two-step in-clinic procedure. First, a blunt cannula severs the fibrous bands tethering depressed scars to deeper skin layers, allowing the scar floor to lift. Then polynucleotide (PN) injections are delivered into the treated zone to support the skin’s natural repair and collagen response. It’s best suited to rolling, anchored and tethered acne scars, and is delivered as a course of three to six sessions spaced several weeks apart. It’s not a surface treatment, and results build progressively as the tissue remodels.
Why This Question Comes Up
Most people who ask about Rejuran scar subcision have already tried something for their scarring, and it hasn’t shifted things the way they expected. Topical actives, standard peels, even some laser treatments, all work on the surface of the skin. But depressed acne scars like rolling scars and tethered scars aren’t a surface problem. They’re held in place by fibrous tissue underneath.
That’s why subcision exists as a category. It’s not about what you put on the skin, it’s about what you physically release beneath it. The Rejuran component adds polynucleotide support to that mechanical release, giving the skin’s repair response something to work with in the treated zone.
Understanding the two steps separately makes the combined treatment much easier to evaluate.
What Is Subcision?
Subcision is a minimally invasive procedure that uses a blunt cannula inserted just below the skin’s surface to sever the fibrous bands holding a depressed scar down.
When acne heals, it sometimes leaves behind fibrous strands that run between the scar base and deeper structures in the dermis or subcutaneous tissue. These strands physically tether the scar floor downward, which is why some scars appear as indentations or visibly deepen when you smile or move your face. They’re not responding to treatments applied to the surface because the problem is structural, not superficial.
Subcision inserts a blunt-tipped cannula through a small entry point and sweeps it beneath the scar to mechanically break those fibrous attachments. Once the tethering is released, the scar base can lift and move toward the surrounding skin level. The motion also creates a controlled micro-trauma in the subcutaneous layer, which triggers the skin’s natural wound healing and collagen remodelling response.
A blunt cannula is used rather than a sharp needle specifically to reduce the risk of inadvertent damage to surrounding structures, which is why bruising is common but the procedure remains minimally invasive in skilled hands.
What Are Polynucleotides (PN)?
Polynucleotides are long chains of nucleotides derived from purified salmon or trout DNA, and they’re the active component in Rejuran treatments. In the context of scar subcision, they’re injected into the zone that has just been mechanically disrupted by the cannula.
Polynucleotides work by promoting the skin’s natural repair pathways rather than delivering volume the way a filler would. They’re associated with stimulating fibroblast activity, which is relevant because fibroblasts are the cells responsible for producing collagen and elastin. In the treated zone after subcision, introducing polynucleotides is thought to support the tissue rebuilding that follows the mechanical release.
The key distinction from dermal filler is that polynucleotides don’t physically fill the scar. They support the skin’s own response to what the subcision has done. The repair happens biologically, not mechanically, which is why results from Rejuran scar subcision are gradual and build over multiple sessions.
For more on how SDL uses Rejuran across different treatments, see our Rejuran treatment overview.
How Rejuran Scar Subcision Works Step by Step
The two steps happen in the same session, sequenced so the polynucleotide injections follow immediately after the subcision work is complete.
- Consultation and diagnostic assessment. Your dermal specialist maps the location, type and depth of your scarring before any treatment begins. Not every scar suits subcision, so this assessment determines which areas are appropriate candidates and what the treatment plan should look like.
- Numbing. Topical anaesthetic is applied to the treatment area well before the procedure begins. The blunt cannula technique is generally more comfortable than needle-only approaches, but numbing is standard preparation.
- Subcision. The cannula is inserted through a small entry point and guided beneath each targeted scar. The practitioner sweeps the cannula to release the fibrous tethering bands. The number of entry points and the area treated depends on your scar distribution and the session plan.
- Polynucleotide injections. Rejuran PN is then injected into the disrupted zones. This introduces the regenerative support directly where the tissue has been released and the healing response is already activated.
- Aftercare guidance. Your practitioner will cover what to expect in the days following treatment, including any activity restrictions and skincare adjustments for the recovery window.
A course of treatment at SDL Australia typically involves three to six sessions spaced several weeks apart, with the exact number based on your individual scar pattern and how your skin responds as the sessions progress.
Which Scars Rejuran Scar Subcision Suits
Not all acne scarring is suitable for subcision. The procedure works on scars that are held down by fibrous tethering, which is a specific structural characteristic rather than a feature of every scar type.
Rolling Scars
Rolling scars present as soft, undulating depressions across the skin’s surface, often giving the appearance of gentle waves rather than defined pits. They’re typically caused by fibrous bands pulling the skin downward at multiple points, so they respond well to the tethering-release mechanism of subcision. The broad, soft shape of rolling scars makes them one of the most consistently responsive scar types for this approach.
Anchored or Tethered Scars
Tethered scars are identifiable by how they behave with facial movement: they deepen or pull visibly when you smile, frown, or stretch the skin. That movement-related distortion is a direct indicator of strong fibrous attachments connecting the scar base to deeper tissue. Subcision specifically addresses these connections, and the anchored scar type is often where the visual improvement is most noticeable once tethering is released.
Shallow Atrophic Scars
Shallow atrophic scars sit closer to the surface as soft, subtle depressions. They may have some fibrous element but often less defined tethering than rolling or anchored types. A more refined subcision approach paired with the polynucleotide support component of Rejuran can still benefit these scars as part of a broader correction plan, though outcomes depend on individual scar characteristics assessed at consultation.
Scars That Are Generally Not Suitable
Ice pick scars are narrow, deep and column-shaped with minimal fibrous tethering, so subcision cannot address their structure. Boxcar scars with sharply defined vertical walls are also generally less suited to subcision alone, though they may be addressed through other approaches like TCA Paint or eCO2 laser as part of a broader skin correction pathway. Your dermal specialist will be direct about what subcision can and can’t do for your specific scarring during consultation.
Downtime and Recovery
Bruising is the most expected and consistent side effect of subcision, and it’s worth planning for it. Because the cannula is working in the subcutaneous layer, bruising in the treated areas is common and can take up to seven to ten days to fully settle. Most people return to normal activities within a few days, though full recovery can take up to two weeks depending on how many areas were treated and how your skin responds individually.
Mild swelling and tenderness around the treated sites are also typical in the first few days. These are expected responses to the tissue disruption, not signs that something has gone wrong.
For the 24 to 48 hours after treatment, harsh actives (retinoids, strong acids), heat exposure, and strenuous exercise should be avoided to allow the treated zone to begin healing without additional stress. Daily SPF is essential throughout the course of treatment, particularly given Australia’s UV levels.
Because results from Rejuran scar subcision build progressively as the tissue remodels and new collagen forms, improvement isn’t always immediate or dramatic after a single session. The gradual nature of the results is part of how the treatment works, not a limitation of it.
How Rejuran Scar Subcision Compares to Other Scar Treatments
Subcision addresses the structural cause of tethered scarring in a way that surface-only treatments cannot. Here’s how it sits alongside the other scar correction options SDL offers.
| Factor | Rejuran Scar Subcision | eCO2 Laser | TCA Paint |
|---|---|---|---|
| Mechanism | Mechanical release of fibrous tethering + PN support | Fractional CO2 laser resurfacing, triggers collagen remodelling | Targeted chemical applied precisely to individual scar |
| Best suited to | Rolling, anchored and tethered acne scars | Deep texture, broad scarring, pigmentation | Individual defined scars (ice pick, boxcar) |
| Works at | Subcutaneous layer, beneath the scar | Mid-to-deep dermis via laser columns | Surface and upper dermis of the scar itself |
| Downtime | Bruising, 7–10 days typical | Required, varies with depth | Localised, generally minimal |
| Sessions | 3–6, spaced several weeks apart | Structured course, results build over months | Precision spot treatment, often combined with other correction |
These treatments are also frequently combined. Subcision and eCO2, for example, address different structural elements of the same scarring, and SDL’s dermal specialists often sequence them based on what your scan shows and how your skin responds. For a fuller picture of the scar treatments available, see our article on eCO2 laser for acne scars.
The SDL Pathway Approach
Rather than treating subcision as a standalone procedure, SDL Australia sequences it within a structured four-phase pathway based on what your diagnostic scan actually shows about your scarring.
The pathway starts with Skin Preparation and Barrier Strengthening before any correction treatment begins. This matters for scar subcision because the skin needs to be in a stable, non-inflamed state to heal effectively after the mechanical disruption of the cannula. Moving into correction on compromised skin risks a slower, less predictable recovery.
Once the correction phase begins, Rejuran scar subcision is sequenced and spaced based on your skin’s response between sessions. Combination approaches with other modalities like eCO2 or TCA Paint are discussed at consultation depending on your scar types, not applied by default. The refinement and retainment phases that follow are designed to compound and sustain the correction results over time.
For more on how SDL approaches skin correction broadly, see our guide on the difference between skin health, correction and maintenance.
See every treatment SDL Australia uses for acne, congestion, scarring and enlarged pores in one place.
Not sure if Rejuran scar subcision is right for your scarring?
Book a consultation with SDL Australia. We’ll run a diagnostic scan and map the pathway that actually fits your skin and your scar type.
Frequently Asked Questions
Is Rejuran scar subcision painful?
Most patients tolerate the procedure well with topical numbing applied beforehand. A blunt cannula is generally more comfortable than needle-only subcision techniques. Your practitioner will discuss comfort options during consultation and can adjust their approach based on your response.
How many sessions of Rejuran scar subcision will I need?
Most patients have between three and six sessions, spaced several weeks apart. The exact number depends on the extent and type of your scarring and how your skin responds between sessions. Your dermal specialist will tailor the schedule during consultation and adjust it as your treatment progresses.
What’s the downtime after Rejuran scar subcision?
Bruising is the most common temporary effect and can last seven to ten days. Mild swelling and tenderness are also typical. Most patients return to normal activities within a few days, though full recovery may take up to two weeks depending on how many areas were treated.
Can Rejuran scar subcision be combined with other treatments?
Yes, and combination approaches are often discussed during consultation depending on your scar types. For example, subcision for rolling and tethered scars is frequently paired with laser resurfacing or TCA Paint for other scar types in the same skin. Less intensive options are typically considered first before layering additional modalities into the plan.
Does subcision work on ice pick scars?
Ice pick scars are generally not suited to subcision. They’re narrow, deep and column-shaped with minimal fibrous tethering, which means the mechanical release mechanism of the cannula doesn’t address their structure. TCA Paint is typically the more appropriate approach for ice pick scars and is discussed at consultation.
How is Rejuran scar subcision different from regular subcision?
Standard subcision uses only the mechanical release of the cannula. Rejuran scar subcision adds polynucleotide injections into the treated zone in the same session. The PN component doesn’t fill the scar, it supports the skin’s natural repair response in the area that’s just been mechanically disrupted, which is intended to enhance what the tissue does during the healing window.
