Subcision: a further modification, an ever continuing process

Abstract

Subcision is a surgical technique used mostly to manage depressed scars. Over time, many modifications to this surgical technique have been made by various surgeons in order to make it simpler and more effective. We report here a new technique that aims to combine the privilege of the prevention of penetrating the skin beyond the scar and maintaining a horizontal orientation, while taking the advantage of the ergonomics of having the dominant hand parallel to the skin surface and the cylindrical grip of a 3 cc syringe. The purpose of our technique is to make subcision more practical and easier for the surgeon.

Figure 1

(a) The tip of the plier is positioned just proximal to the bevel of the needle. (b) The needle is bent with an upward motion till it reaches 90-degrees, creating the first angle. (c) The tip of the plier is moved 1-2 mm proximal to the first angle and a second 90-degree angle is created opposite to the direction of the first angle.

Figure 2

(a) The final shape of the hypodermic needle. (b) The same technique may be applied to a Nokor needle. (c) The modified hypodermic needle attached to a 3 cc luer lock syringe.

Figure 3

The parallel alignment of the needle to the skin surface conforms an ergonomic motion while serving the purpose of the final configuration of the needle, that is, preventing penetration of the skin beyond the scar and maintain a horizontal orientation of the needle tip.