What makes a scar a rolling scar
Rolling scars are broad, wave-like dips, usually wider than about 4 to 5 mm. The dip is held down by a fibrous band beneath the skin.
Stretching the skin beside the scar, and watching it move, give useful clues about a tether. Dr Sin Yong examines each scar and decides, one by one, what it needs.
Rolling scars treatment Singapore: why order matters
The band sits below the level that lasers and radiofrequency reach. Resurfacing a tethered scar treats a dip that is still being pulled down, so the change tends to plateau. That is why release comes first. Once the band is divided, the floor can be supported where it has thinned, and the surface can then be refined. Release and resurfacing may be done at one visit or staged. The choice depends on your scars, your skin type and how much bruising is expected. Energy alone does not change the depth of a tethered scar for long, so it follows release and does not replace it.
What happens at the release visit
Each scar is marked and examined at rest and in movement. Local anaesthetic is infiltrated first. A fine needle or blunt cannula enters through a small puncture beside the scar and moves in a fanning pattern beneath it, in the subcutaneous plane. You may notice a give or a faint snap as a band divides. Firm pressure then limits bleeding and bruising, and the entry points heal on their own. Sun protection is advised while bruising settles. Declare all medicines and supplements that affect bleeding before you book, since these can change the plan.
The steps in order
Which tool does what
| Tool | Used for | What it does not do |
|---|---|---|
| Subcision | Dividing the tether | Resurface texture, soften edges or reach an ice pick tract |
| Radiesse | A thin floor after release | Lift a scar held by an intact tether, or change edges or texture |
| Secret DUO | Shallow rolling scars and texture, using insulated microneedles that spare the surface | Cut a band or reach a deep, narrow floor |
| S3 Resurfacing Lift | Deep rolling scars and steep edges, with point shots then fractional passes | Release a tether or replace volume |
| FSX Laser | Superficial texture between scars | Reach deep scars or release a tether |
Who this suits
It suits scars confirmed as tethered on examination. Shallow rolling scars lean towards Secret DUO, and deep ones with steep edges lean towards the S3. Skin type shapes the plan too. Insulated needles are generally preferred in Fitzpatrick IV to VI, and staging is often the more conservative choice in Fitzpatrick III to V, where inflammation can leave pigment behind. Rolling scars often sit beside boxcar and ice pick scars, so the whole face is mapped first.
Who should wait or be reviewed first
Control comes first, because new acne can leave new scars.
This is reviewed before any plan.
These matter for subcision, so declare all medicines.
This is weighed at assessment.
These are referred to a plastic surgery specialist for a punch technique, which is not done here.
Subcision waits in pregnancy and while there is active infection in the area.
What treatment cannot do
No outcome is promised, and some scars respond less than hoped.
The band can partly re-form, which is why release sits inside a staged plan.
Energy alone does not change the depth of a tethered scar for long.
Ice pick tracts and boxcar walls need other tools, as in the ice pick and boxcar guides.
Radiesse does not lift a scar held by an intact tether.
Neither S3, FSX nor Secret DUO releases a tether.
The S3 does not replace volume, so a thin floor may need support.
Risks and side effects
Bruising, lumps, infection, pigment change and a poorer response than hoped are all possible. In Fitzpatrick III to V skin, inflammation carries a post-inflammatory pigment cost. That is one reason stages may be separated. Small firm lumps can form after subcision, and these are reviewed. Radiesse can cause swelling or bruising at injection points. Seek same-day attention for increasing pain, spreading redness or warmth, pus, or a firm lump that grows or hurts.
What recovery looks like
Bruising, swelling and tenderness settle over time. The procedure itself feels like pressure and movement rather than sharp pain for most people.
Swelling or bruising may appear at injection points.
Redness and pinpoint marks settle over days.
Expect redness, swelling and fine crusting while the channels close.
Redness settles, with a shorter recovery than S3.
Stages may be separated so that bruising and resurfacing inflammation do not overlap, especially in Fitzpatrick III to V skin.
Sessions and fees
The number of sessions is not fixed. It depends on how many scars are tethered, how they respond and what your skin allows. Your written plan sets out the steps and the fee factors after examination. Every plan is reviewed as you go, so later stages can change. Results vary. Filler, if any, and each resurfacing step are added only as review supports them. Each released scar is reviewed before the next stage is booked. The wider order of steps is described under 4D Scar Reconstruction.