Rolling atrophic scars – relatively broad depressions in the skin that have rounded, sloping edges.
The combination of several of these types of scars in a region of skin gives it a rolling appearance, hence the name. Note the loss of dermis and fat under the skin.
There is thinning of the dermis and fat under the skin. Thus the rolling scar “sinks” lower than the level of the surrounding skin. Often tight scar tissue forms which is not necessarily observable from the outside.
This classic rolling cheek scar was treated with subcision and filler.
Rolling scars are common for in individuals who have had patches of skin that have been afflicted by long term inflammatory acne. They tend to become more pronounced as the skin ages and loses its original elasticity and fullness. A mini facelift often releases and improves such scars.
There is thinning of the dermis and fat under the skin. Thus the rolling scar “sinks” lower than the level of the surrounding skin. Often tight scar tissue forms and locks and binds the depressed skin to deeper tissues.
Rolling scars have rounded, sloping borders, and there are scar treatment techniques capable of producing positive results.
Only treatments which deal with the fundamental loss of thickness of the dermis and underlying fat will raise the skin to the level of the surrounding skin.
Cosmetic fillers are also occasionally used, but many times the large size of the affected area makes fillers an unappealing financial option. In softer scars, they are able to push the depressed skin up to the level of surrounding skin. In such cases, fillers become a desirable option.
Unfortunately, there are many such scars that are held down so tightly that injection alone is not able to push up the skin.
In such cases, a procedure called subcision is performed. Excision is to remove something from the outside; or incise to cut into it To subcise, is to cut something from below. This is possible to perform via a tiny hole which cannot be seen after healing. Special needles are made for this purpose.
After the underlying scar is released, filler material may be injected into the released space, helping to push up the skin.
This is the most effective way for treatment of such scars.