Dermaspacing, also known as subcision, by contrast, is a simple, safe and rapid office procedure designed to stimulate the skin to produce its own collagen.

Until very recently, traditional treatments for wrinkles and depressed scars involved the use of soft tissue filler substances, such as injectable collagen replacement therapy or hyaluronic acid, also referred to as soft tissue augmentation.

These treatments require the injection of purified materials directly under the wrinkles or depressions to elevate them to the surface. The materials are made in the laboratory, and in some cases skin tests must be performed before treatment in order to minimize the chance of allergic reactions. Moreover, repeat touch up injections are typically required every several months in order to maintain the optimum correction.

With dermaspacing, no foreign or processed material is implanted. While it is uncertain how long the correction may be maintained in any individual, because the skin has been encouraged to produce its own collagen, it is reasonable to anticipate that the correction may persist for an extended period.

How Dermaspacing Works

Immediately prior to starting, the cosmetic surgeon generally numbs the region surrounding the wrinkle or scar with a small amount of local anesthetic, making the procedure entirely painless.

Then, using a fine needle inserted into the skin, the tissue in the dermis is separated directly under the length of the wrinkle or scar to create a small, narrow pocket or space. During the next several weeks, the skin responds by producing new collagen to fill in the space created, thereby plumping the skin and correcting the wrinkle or scar directly above.

Doctors use the term excision to refer to a surgical procedure in which a deep cut is made through the surface of the skin, usually by some cutting instrument, such as a scalpel. For this reason, excisional procedures generally leave a small skin scar. The term dermaspacing is used because, except for the initial needle prick, no cuts are made along the surface of the skin.  All work is done below the skin, virtually eliminating the possibility of surface scarring. And the needle prick site generally heals imperceptibly, as well.

Indications for Dermaspacing

"Worry" lines along the forehead, "scowl" lines between the eyes, and "laugh" lines, "marionette" lines and "smoker's" lines around the mouth are particularly well suited to this technique, which usually only requires a few minutes to perform during an office visit.

Depressed acne scars, chicken pocks scars, and certain linear, depressed traumatic scars are also amenable to this approach.

What To Expect Afterward

Immediately afterward, the surface of the skin along the entire length of the wrinkle or scar, generally appears bruised and slightly swollen due to the leakage of blood into the space created below the surface. This bruising is harmless and typically clears by itself in about two to seven days.  In addition, on the skin surface, there may be one or more tiny needle prick marks where the anesthetic was administered and where the dermaspacing needle entered the skin. However, these seal quickly and, if desired, coverup makeup may be applied immediately after the procedure. Some individuals experience minimal tenderness at the treatment site, which usually resolves in a day or so and may be treated with ice packs and acetominophen (e.g. Tylenol) if necessary.

Cosmetic improvement is best appreciated between two and four weeks after dermaspacing. It is not uncommon for one or more repeat procedures to be performed in order to maximize the overall cosmetic result. If needed, the procedure can be repeated in about a month.

Possible Complications

Although low, there is a risk of scarring believed to be related to an overabundant production of collagen in response to treatment. Usually, this appears as a small, flesh-colored bump protruding above the skin surface that often slowly disappears on its own.  Particular areas of the face and certain individuals may be more prone to this problem. Should it persist, however, it can be easily treated.

Limitations

Dermaspacing is not intended to remove deep "pit" scars. For these punch grafting, punch elevation, scar excision, chemical peeling, laser resurfacing and buff-peeling can be much more effective either alone or in combination.