Taylor Liberator Subcision For Acne Scars

Taylor Liberator Subcision for Acne Scars; At A Glance

  • Best Results1-2 sessions
  • Treatment Recovery5-10 days
  • Procedure Time20-60 min
  • Skin SpecialistDavin Lim
  • Duration of ResultsLife (if acne controlled)
  • AnaestheticBlocks, sedation
  • Back to Work2-9 days
  • Cost$$ Partial Medicare rebate in most cases

Taylor Liberator Subcision For Acne Scars

Subcision is a surgical procedure akin to keyhole surgery. It can be performed by dermatologists & plastic surgeons using many instruments including the Taylor Liberator, cannulas, modified blades, Nokor Needle, hook devices, flat instruments & sharp stripping instruments. This procedure is best reserved for severe tethered scars involving facial areas. Subcision is often combined with lasers, RF microneedling & deep focal peels. 

FactsFacts on Taylor Liberator Subcision for Scars

  • Subcision is keyhole surgery to revise scars
  • An entry is made next to scar tissue & an instrument is introduced
  • Instruments include cannulas, needles, stripping & cutting tools
  • The Taylor Liberator is one such instrument invented by Mark Taylor
  • This device can cut & breakdown the most severe of acne scars
  • The large diameter & sheer heft is resistant to bending forces
  • I reserve this instrument for extreme cases of scarring in the mid & lower one-third of the face

What is surgical subcision?

Taylor Liberator Subcision

Surgical subcision is a procedure that releases attachments to the mid layer of skin (dermis).

The majority of severe acne scars will have tethering that attach scars from the deep fat layer to the lower to mid dermal layer. Think of it as a cord of thick fibrous tissue that pulls the surface of the skin down. Subcision transects this tissue at various levels.

How to tell if you are a candidate for subcision?

Subcision is best reserved for acne scars with deep attachments. In most cases a real time clinical examination is required. Diagnostic clues include-

  • Tethering or puckering at rest
  • Tethering upon animation (smile, grin, frown)
  • Inability to distend skin upon gentle stretching (Grade 4/B scars)
  • Fibrosis upon palpation
  • The dimple sign-squeeze either side of the scar. If there’s a dimple, there’s probably an attachment to the deep layers of skin
scar removal brisbane
Cases like this requires subcision (proper subcison, not just needle)

What is unique about the Taylor Liberator?

Surface area & force are the two stand out features of the Taylor Liberator. The heft of this instrument makes it a great device when I really want to break up severe scar tissue. Unlike fine cannulas & needles, the Liberator can withstand the greatest amount of resistance. It is not malleable, unlike cannula & needles.

For severe scars with thick fibrous tissue, I subcise with modified cutting & stripping cannulas ranging from just over 1.0 mm to 4.0 mm surface area. These cannulas allow me to ‘bend’ around a curved area. For scars that have more resistance, I employ the Taylor Liberator.

What types of scars respond best to Taylor subcision instruments?

Rolling, tethered & anchored scars respond best to this procedure. Severe rolling scars located in the middle & lower one third of the face is when I use the Taylor Liberator the most.

In most cases I combine other forms of subcision with the Liberator. This allows fine control of instrumentation based upon the depths of scar tissue.

subcision for scars
The greater the selection of instrumentation, the better the treatment. Apply instruments as required or called upon. Taylor’s instrument is the W shaped large bore instrument to the far left.

Davin’s Viewpoint; Taylor Liberator Subcision

This is a very useful instrument if the job calls for it. I cannot understand how some surgeons advertise that they are the only one in the country performing this procedure. It is like a carpenter advertising they exclusively use a sledgehammer for every job. 

The Taylor Liberator is indicated for severe acne scars with marked tethering in the hypodermis. Subcision is much better (more extensive, easier, more efficient) with the Liberator in this context. I employ very large volumes of hydro dissection tumescent as this provides an easier & much safer plane. Most of my subcision procedures are in at least 2 levels, with finer instruments in the upper & lower most level.

One has to be mindful of potential side effects including intra & post-operative bleeding with any form of subcision. The sharper & larger the gauge (diameter/surface area), the higher the incidence of haemorrhage, haematomas & resultant fibrosis.

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