Efficacy of Combined Subcision and Microfocused Ultrasound With Visualization for Improving Atrophic Acne Scars: A Split-Face Randomized Comparative Study

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ID: 337467
2026
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Abstract
Abstract Background Subcision effectively treats atrophic acne scars but often requires combination therapy for optimal results. Microfocused ultrasound with visualization (MFU-V) induces neocollagenesis and may enhance outcomes, but prior studies are limited by small, non-randomized samples. Objectives This study aims to compare the efficacy and safety of combined subcision and MFU-V to subcision monotherapy in the treatment of atrophic acne scars. Methods Forty participants with mild-to-severe atrophic acne scars underwent a split-face randomized trial: one side received subcision monotherapy, the other combined subcision and MFU-V. Outcomes assessed at baseline, 1, 3, 6, and 9 months include depression volume (mm3), physician-graded acne scar severity, and patient-reported satisfaction, pain, and adverse events Results Direct between-group comparison of depression volume reduction did not reach statistical significance at any time point (p>0.05). Within-group analysis demonstrated a faster onset of statistically significant improvement in the combined therapy group at 6 months (p=0.036) compared with 9 months in the monotherapy group (p=0.007). Physician-graded acne scar severity showed statistically significant between-group differences, favoring combined treatment from 3 months follow-up onwards. Adverse events included ecchymosis (92.5%), edema (72.5%), and transient nodules (17.5%), all self-limited. Conclusions Both subcision monotherapy and combined subcision with MFU-V may be safe and effective treatments for atrophic acne scars. Although objective assessment of depression volume reduction did not yield statistically significant between-group differences, subjective physician evaluations revealed notable distinctions favoring the combined approach from 3 months onwards.
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Authors Natthachat Jurairattanaporn, Sonphet Chirasuthat, Suphagan Boonpethkaew, Sasipim Chaijaras, Pimsiri Anansiripun, Waritta Dararattanaroj, Panupong Pornsirianant, Natnicha Anuntaprayoon, Tanat Yongpisarn, Nawara Sakpuwadol, Vasanop Vachiramon
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Journal Aesthetic Surgery Journal Open Forum
Year 2026
DOI
10.1093/asjof/ojag212
URL
https://doi.org/10.1093/asjof/ojag212
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