Laser-Induced Optical Breakdown (LIOB) functions by generating microscopic plasma explosions within the skin to physically restructure scar tissue. When a picosecond laser is focused through a Micro-lens Array (MLA), it triggers multi-photon ionization. This creates a plasma cloud that ablates specific tissue points, forming vacuoles that break the fibrous bands holding a scar down, allowing the skin to lift.
The central value of LIOB is that it acts as a non-invasive subcision technique. Instead of cutting skin from the outside, it uses focused light to create controlled internal voids that release the tension causing the depression.
The Physics of the Mechanism
To understand how LIOB treats depressed scars, we must look at the chain reaction triggered by the laser optics.
The Role of the Micro-lens Array (MLA)
Standard laser beams cover a broad area. To achieve LIOB, a picosecond laser must be paired with a Micro-lens Array.
This specialized optic component fractionates the beam. It concentrates the energy into extremely intense, microscopic focal points required to breach the optical breakdown threshold.
Multi-Photon Ionization
At these concentrated focal points, the energy density becomes high enough to strip electrons from their atoms.
This process is known as multi-photon ionization. It results in the rapid creation of a plasma cloud consisting of free electrons.
Plasma-Mediated Ablation
This plasma cloud is highly energetic and expands instantly.
The expansion vaporizes a microscopic portion of the tissue. This ablation occurs without relying on traditional heat transfer, making it a mechanical rather than purely thermal event.
Biological Impact on Scars
The physical reaction creates immediate structural changes within the dermis that lead to scar improvement.
Formation of Dermal Vacuoles
The ablation process leaves behind tiny cavities or empty spaces inside the skin, known as vacuoles.
These vacuoles are formed deep within the dermis. Crucially, this happens while leaving the epidermis (the skin's surface) intact.
The "Subcision-Like" Effect
Depressed scars are often tethered downwards by rigid, fibrous bands of collagen.
The creation of vacuoles acts to sever or release these fibrous bands. This mirrors the surgical technique of subcision, where a needle is used to cut bands, but LIOB achieves it using light energy.
Lifting Depressed Tissue
Once the fibrous bands are released, the downward tension on the skin is resolved.
This allows the depressed tissue to rise. Over time, the body rushes to heal the microscopic vacuoles, stimulating new collagen production to fill the gaps.
Depth Targeting via Wavelength
Not all scars sit at the same depth.
By adjusting the laser wavelength, practitioners can control exactly how deep the light penetrates before the breakdown occurs. This ensures the vacuoles are created precisely where the scar tissue is densest.
Understanding the Constraints
While effective, the LIOB mechanism operates under specific physical constraints that define its utility.
Dependence on Pulse Duration
LIOB relies on the extreme peak power of picosecond lasers.
Slower laser pulses (like nanosecond or millisecond) generally cannot generate the peak intensity required to trigger the plasma cloud needed for this specific breakdown.
Specificity of the Optics
The mechanism is strictly tied to the use of the MLA.
Without the Micro-lens Array to focus the beam, the laser acts as a standard photothermal device. It requires the MLA to transition from heating tissue to physically ablating it via ionization.
Making the Right Choice for Your Goal
LIOB represents a shift from bulk heating to precise, plasma-mediated structural remodeling.
- If your primary focus is releasing tethered scars: LIOB provides a "subcision-like" effect that physically breaks the fibrous bands pulling the skin down.
- If your primary focus is depth precision: The ability to adjust wavelengths allows the mechanism to target the specific level of the dermis where the damage exists.
Ultimately, LIOB harnesses the physics of ionization to mechanically remodel depressed scars from the inside out, offering a potent alternative to invasive surgical revision.
Summary Table:
| Feature | LIOB Mechanism Detail |
|---|---|
| Energy Source | Picosecond Laser with Micro-lens Array (MLA) |
| Physical Process | Multi-photon ionization & plasma cloud formation |
| Tissue Impact | Formation of dermal vacuoles (internal voids) |
| Clinical Effect | Releases fibrous bands & lifts depressed tissue |
| Recovery Advantage | Intact epidermis with minimal thermal damage |
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References
- Beom Jun Kim, Eun Soo Park. Combination treatment for post-traumatic facial scars: 1,064-nm Nd:YAG picosecond laser with micro-lens array after fractional ablative CO<sub>2</sub> laser. DOI: 10.25289/ml.2022.11.2.92
This article is also based on technical information from Belislaser Knowledge Base .
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