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The concept of "bound down"

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I am not a Doctor, nor do I play one on TV. But I was wondering about this... We repeatedly hear about the concept of a depressed scar being created, because the underlying damage is pulling the upper level of skin down, which creates the indentation. Then supposedly, "breaking up" that which lies beneath the surface and basically 're-damaging' it, and creating new collagen through needling, cross and other techniques, is supposed to allow the top surface of skin to level out. What I'm wondering is... How is this damage that is being created on purpose any different than the damage created in the first place?

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