Filler vs Subcision for Acne Scars — Which One, or Both Together
Filler vs Subcision for acne scars · how they differ · which scars · cost · risks. Dr. Big compares honestly · Clarity Clinic Ratchathewi, near BTS.
Quick answer: Neither is universally better — it depends on the scar. Subcision releases the fibrous bands at the root and builds lasting lift from your own collagen, best for rolling and box scars; HA filler instantly fills deep atrophic scars but dissolves in 6–18 months and needs refilling. Dr. Big usually uses Subcision as the core, adding filler to top up spots that aren’t fully shallow, for overall ~60–80% improvement.
“Is filler better for acne scars, or Subcision?”
Dr. Big hears this weekly — and the answer isn’t “which is better” but “which suits which scar.” Some cases need only Subcision, some need filler as a supplement, some aren’t suitable for filler at all.
How they work — different roots
Subcision = cutting the “fibrous band” that pulls the scar
Acne scars come from fibrous bands tethering the skin down · Subcision uses a cannula under the skin to release them → the skin lifts. Works at the root cause.
Read more: What is Subcision.
Filler = adding “material” into the scar
HA (Hyaluronic Acid) is injected beneath the scar to fill the depression to the surrounding level. Compensates for what’s missing.
Subcision fixes the root cause · filler masks the symptom — both have distinct strengths.
Comparison
| Factor | Subcision | HA Filler |
|---|---|---|
| How it works | Releases bands | Fills under the skin |
| Result | Lift from new collagen | Smoothness from injected material |
| Lasts | Permanent (with maintenance) | 6–18 months · needs refilling |
| See result | 4–12 weeks | Immediate after injection |
| Suits | Rolling, box scars | Rolling, deep atrophic |
| Not for | Ice pick | Ice pick, hypertrophic |
| Pain | Moderate | Low |
| Downtime | Swelling 2–3 days | Swelling 1–2 days |
| Risk | Low (skilled doctor) | Vascular occlusion (rare) |
Which scars each suits best
Subcision: ✅ rolling scars · ✅ wide box scars · ❌ ice pick (too narrow) · ❌ pit-type. Filler: ✅ large rolling scars · ✅ old atrophic scars Subcision didn’t lift fully · ❌ ice pick · ❌ hypertrophic.
Read more: Acne scar types and Rolling scars — HA + PDLLA.
HA fillers for acne scars — which
Restylane · Juvederm · Belotero. ⚠️ Never use permanent fillers (silicone, PMMA) — they stay forever and are hard to correct.
Total cost over a year
Subcision only (3–5 sessions): 15,000–25,000 baht (Clarity) · permanent with maintenance. Filler only: 1 session 15,000–25,000 baht (genuine 1cc in Thailand) · refill every 12–18 months · 5 years = 75,000–125,000 baht. Combined (complex cases): best long-term value.
At Clarity — Subcision is in the 5,000 baht/session package · filler is an optional add-on (assessed per case, priced before deciding · price depends on brand and amount).
Who suits filler more
- Wants immediate results (big event in 1–2 weeks) · 2. Afraid of Subcision/downtime · 3. Deep atrophic scars Subcision didn’t shallow · 4. Age 40+ with slow collagen.
Who suits Subcision more
- Age < 35 (good collagen) · 2. Mostly rolling scars · 3. Wants permanent results · 4. Tighter budget.
Frequently asked questions
Q: Is filler for acne scars dangerous? A: Not if a skilled doctor uses genuine HA · very low risk · but never use permanent (silicone) fillers.
Q: Does filler disappear and waste money? A: HA filler gradually dissolves (6–18 months) · doesn’t linger · safe.
Q: Does Subcision hurt more than filler? A: Both are numbed · similar · Subcision feels like “pulling,” filler like “tightness.”
Q: Can I do both the same day? A: Yes in some cases · Subcision first → filler to top up spots still not shallow · Dr. Big assesses first.
Q: Where can I discuss which suits me near BTS? A: At Clarity Clinic Ratchathewi, near BTS Ratchathewi (1-min walk), easy to reach from Siam, Phaya Thai, all of Bangkok — Dr. Big assesses and treats in person, free 30-min consult.
Summary
Subcision = root cause · permanent · best long-term value. Filler = immediate · needs refilling · for specific cases. Dr. Big mostly recommends Subcision as the core, with filler to top up spots not yet shallow · overall 60–80% improvement in 3–5 sessions.
Contact:
- LINE: @clarityclinic — send a photo of your acne scars for Dr. Big to review
- Location: Spring Tower, B Floor · Ratchathewi, near BTS (Siam, Phaya Thai, all Bangkok)
- Free 30-minute consult with Dr. Big in person
- Price 5,000 baht/session including all main procedures · pay per session, no course packages
Read next:
References
Outcomes vary by individual; this article is educational, not a substitute for in-person medical assessment.
- Orentreich DS, Orentreich N. Subcutaneous incisionless (subcision) surgery for the correction of depressed scars and wrinkles. Dermatol Surg. 1995. PubMed
- Jacob CI, Dover JS, Kaminer MS. Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol. 2001. PubMed
- Gozali MV, Zhou B. Effective treatments of atrophic acne scars. J Clin Aesthet Dermatol. 2015. PubMed