title: Blunt Blade Subcision: An Evolution in the Treatment of Atrophic Acne Scars.
abstract: BACKGROUND
  Subcision is the mainstay of atrophic acne scar treatment but the efficacy and safety of the procedure is controversial.
  
  
  OBJECTIVE
  To improve the efficacy of the subcision procedure, a blunt subcision blade was designed and evaluated.
  
  
  METHODS
  Eighteen patients with bilateral atrophic acne scars considered eligible for subcision were enrolled. Before subcision, a tumescent solution was injected subdermally to anesthetize the treatment area and aid the dissection of the dermal-subcutaneous tissue. Patients underwent treatment using the blunt subcision blade, a long metal blade with gradually narrowing edges, and a rounded blunt tip. Early postoperative complications, overall aesthetic improvement and persistent discoloration, or lumpiness were assessed 7 days after subcision and at a 6-month follow-up visit.
  
  
  RESULTS
  Moderate to marked improvement of atrophic scars was observed in 15 cases (83.3%). Mild to moderate tenderness, periorbital ecchymoses, and swelling were reported by some patients, but resolved completely within 1 week after the procedure. No cases of persistent discoloration or lumpiness were observed at the final visit.
  
  
  CONCLUSIONS
  The blunt blade subcision procedure is suggested as an effective method for the treatment of atrophic acne scars.
authors.affiliation: *Laser Application in Medical Sciences Research Center, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; †Center for Research and Training in Skin Disease and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Behrooz
authors.initials: B
authors.lastname: Barikbin
authors.forename: Zahra
authors.initials: Z
authors.lastname: Akbari
authors.forename: Maryam
authors.initials: M
authors.lastname: Yousefi
authors.forename: Yahya
authors.initials: Y
authors.lastname: Dowlati
mesh_terms: D000152:Acne Vulgaris / Q000150:complications*; D000293:Adolescent; D000328:Adult; D001284:Atrophy / Q000601:surgery*; D002921:Cicatrix / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D003357:Cosmetic Techniques / Q000295:instrumentation*; D005145:Face; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult