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Paul B

How to treat untethered rolling scars?

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I have been reading about subcision and how it can be a very effective way of treating rolling scars by snapping the fibrotic tethers that are pulling down the skin and giving the "rolling" appearance.

From what I can make out, you make the determination between a scar that's tethered or untethered based on whether or not it disappears when you lightly stretch the skin or not. If the scar remains visible at all times, it is tethered whereas if goes away when stretched, it is not tethered.

However, if a scar is untethered - does that mean that subcision is not an effective method of treatment, or at the very least not as effective as it could be - and if indeed that is the case - what is the best course of action for untethered rolling scars?

I thought that rolling scars were by definition being pulled down but it seems that this isn't necessarily the case. Or is it that all rolling scars are indeed tethered, just to varying degrees? ie. one's that can't be stretched have significantly harder/firmer tethers than ones that can

Many thanks.

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I have no clue what I'm talking about.

As I understand it, yes, people seem to suggest that subcision works by untethering scars. BUT, as I understand it, it also works by creating scar tissue under the indent to push it up. I don't believe that once a scar is untethered it will magically fill in, it may just not be pulled down as much?

So, for untethered scars I could still see subcision being effective, assuming it's creating scar tissue to push the skin up. If you're wondering about other treatments then I imagine derma-fillers would do the same thing. Other potential treatments include derma rolling and suctioning - these are probably less effective than the first two options.

Again, I have no idea what I'm talking about.

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I think you are right in as much as subcision creates a wound under the surface of the skin which should raise the level of the effected area. Whenever I look up a description of what subcision is though it always seems to refer to the process of cutting the strands that are holding the scar down. If there's no tethering to cut - it could either mean that:

1) Subcision is not effective
2) Subcision is more likely to be effective (because it doesn't rely on all of the tethers being cut because they don't exist)

I posed the question because I have read some comments on here to suggest that if your scars aren't tethered - then subcision isn't the appropriate solution. However, I'm trying to establish if this is true or just down to other people's misunderstanding of how subcision works?

I will continue to research the matter and will report back with my findings, but in the meantime if someone in the know can answer this question for me it would be much appreciated!

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