The combination of subcision and energy-based devices is recommended because it targets the scar pathology on two distinct physical levels simultaneously. Subcision mechanically releases the deep fibrous bands tethering the skin downwards, while energy devices trigger thermal remodeling to tighten tissue and restore volume. This dual approach provides superior outcomes by ensuring the skin is not only un-tethered but also actively rebuilt.
A standalone treatment often addresses only half the problem; subcision releases the anchor, but energy devices are required to smooth the surface and rebuild the underlying structure.
The Structural Challenge of Rolling Scars
The Role of Fibrous Adhesions
Rolling scars are defined by fibrous band adhesions located in the subcutaneous tissue. These bands act like anchors, pulling the surface of the skin downward and creating a wave-like depression.
The Limitation of Surface Treatments
Because the root cause lies deep within the tissue, topical treatments or superficial resurfacing cannot resolve the issue. The skin is physically tethered to the deeper structures.
The Power of Synergistic Action
Subcision: Mechanical Release
Subcision is the primary intervention for the "anchoring" problem. By inserting a needle or cannula under the skin, the practitioner physically severs the fibrous bands. This allows the depressed skin to snap back up to a neutral position.
Energy Devices: Thermal Remodeling
Once the tether is cut, energy-based devices—such as fractional lasers or radiofrequency—provide essential thermal stimulation. This heat injury triggers a wound-healing response known as volume recovery.
Simultaneous Skin Tightening
Beyond simply healing, the thermal energy induces collagen contraction and remodeling. This creates a skin-tightening effect that smooths the surface texture while the underlying tissue fills in.
Why Lasers Alone Are Insufficient
Depth of Penetration
Micro-ablative fractional lasers create columns of thermal injury to stimulate collagen. However, the energy penetration of these devices often cannot reach the depth of the fibrous bands found in rolling scars.
Inability to Break Tethers
Even if the laser energy reaches the correct depth, thermal stimulation alone is rarely enough to snap thick fibrous adhesions. Without physically severing these bands via subcision, the skin remains pulled down regardless of new collagen production.
Understanding the Trade-offs
Increased Recovery Time
Combining two aggressive modalities often creates more significant trauma to the tissue than a single treatment. Patients should anticipate a longer downtime, including potential bruising from the subcision and redness or peeling from the energy device.
Complexity of Procedure
This is not a "lunchtime" procedure; it requires a skilled practitioner who understands both surgical subcision techniques and laser physics. Poor technique in subcision can lead to hematomas, while improper laser settings can cause hyperpigmentation.
Making the Right Choice for Your Goal
To achieve the best possible outcome for atrophic scarring, align your treatment choice with the specific nature of your scars.
- If your primary focus is deep, tethered rolling scars: Prioritize the combination protocol to ensure the physical anchors are released before attempting to resurface the skin.
- If your primary focus is surface texture or shallow boxcar scars: A standalone energy-based device (like a fractional laser) may be sufficient to smooth the skin without the need for invasive subcision.
- If your primary focus is volume loss without tethering: You may benefit more from fillers or biostimulators rather than the mechanical severing involved in subcision.
True scar revision requires treating the structure below the skin, not just the surface you see in the mirror.
Summary Table:
| Treatment Component | Primary Mechanism | Target Pathology | Key Benefit |
|---|---|---|---|
| Subcision | Mechanical Release | Deep Fibrous Band Adhesions | Lifts tethered skin and eliminates the "anchor" |
| Energy Devices | Thermal Remodeling | Dermal Layer & Surface | Stimulates collagen, restores volume, and tightens skin |
| Combination | Synergistic Action | Full Structural Depth | Comprehensive scar revision with smooth surface results |
Transform Your Practice with Professional-Grade Aesthetic Solutions
To effectively treat complex conditions like rolling scars, your clinic requires the perfect synergy of mechanical technique and advanced technology. BELIS specializes in providing premium salons and medical clinics with high-performance energy-based systems designed for superior clinical outcomes.
Our specialized portfolio includes:
- Advanced Laser Systems: Diode Hair Removal, CO2 Fractional, Nd:YAG, and Pico lasers for precise resurfacing.
- Skin Tightening & Lifting: High-intensity HIFU and Microneedle RF devices for deep thermal remodeling.
- Body Sculpting: EMSlim, Cryolipolysis, and RF Cavitation solutions.
- Specialized Care: Hydrafacial systems, advanced skin testers, and hair growth machines.
Empower your clinic to deliver life-changing results. Partner with BELIS for cutting-edge technology and comprehensive support. Contact us today to upgrade your equipment!
References
- Amin Amer, Mai Samir. Options of Treatment of Post Acne Scar: Review Article. DOI: 10.21608/ejhm.2023.296742
This article is also based on technical information from Belislaser Knowledge Base .
Related Products
- RF Microneedling Machine Micro Needle Radio Frequency Machine
- IPL SHR+Radio frecuency machine
- Hydrafacial Machine Facial Clean Face and Skin Care Machine
- Ultrasonic Cavitation Radiofrecuency Machine for Body Slimming
- 12D HIFU Machine Device for Facial HIFU Treatment
People Also Ask
- How does radiofrequency (RF) microneedling compare to traditional microneedling? Discover the Superior Choice
- How do Microneedle Radiofrequency (RF) devices synergistically improve skin texture and repair scars? Unlock Clear Skin
- What is the key physical function of Radiofrequency Microneedling for hyperhidrosis? Achieve Permanent Sweat Reduction
- What is the role of Radiofrequency (RF) devices with PRP for striae distensae? Boost Synergy for Stretch Mark Repair
- What are the technical advantages of Microneedle RF systems with adjustable depth? Achieve Precise Scar Remodeling
