BonBoz Clinic

Acne Treatment

Rolling scars

Rolling scars are wide depressions measuring 4–5 mm across with sloping edges, giving the skin a wavy, undulating texture when stretched. They are caused by subcutaneous fibrous bands tethering the base of the scar, so treatment typically begins with subcision to release these fibrous bands, followed by laser therapy or microneedling to smooth and even out the skin surface.

Medically reviewed by BS.Ths.CKI Kim Kha — BonBoz Clinic

Identifying Rolling Scars

When you stretch the skin on your cheeks, the depressions almost completely flatten out—this is the hallmark sign of rolling scars, unlike boxcar or icepick scars which remain unchanged when the skin is stretched. The surface resembles rolling waves or soft undulations with no sharp edges. This type commonly appears on the lower cheeks and jawline, where inflammatory acne previously spread.

Why Are Surface Treatments Alone Not Enough?

The root cause of rolling scars lies in the fibrous bands beneath the skin that anchor the scar base to deeper tissues. Lasers or microneedling target the superficial to mid-dermis to stimulate new collagen production; however, if these fibrous bands continue to pull downward, the scar base can hardly lift. Therefore, for rolling scars, dermatologists often consider subcision prior to or during the same session as surface resurfacing methods.

What Is Subcision?

A dermatologist inserts a specialized needle beneath the skin to sever the fibrous bands, releasing the tethered scar base. This controlled subcutaneous trauma also triggers the body to generate new tissue that fills the released space. This is a subcutaneous minimally invasive procedure that must be performed by a physician under local anesthesia; mild bruising may occur for a few days afterward.

How to Properly Combine Treatments?

A common treatment plan involves: subcision for undulating areas, followed by fractional CO2 laser or microneedling RF to refine the skin surface and treat interspersed scars; temporary dermal fillers or PRP may occasionally be added to support recovery as clinically indicated. The sequence and interval between each step are determined by the doctor based on your skin's response.

What We Do at BonBoz

Our dermatologists assess your skin under magnification, perform skin-stretching tests to classify each scarred area, mark the zones requiring subcision, and discuss a customized combination plan, the estimated number of sessions, and expected downtime. The degree of improvement varies depending on individual skin response and scar depth; our doctors will clearly communicate what can and cannot be achieved before you make a decision.

Severity levels

1

Superficial — faint waviness under angled lighting

A few soft depressions that flatten almost completely when the skin is stretched. Can be improved with laser or microneedling, without requiring subcision.

2

Moderate — distinct rolling texture

Multiple broad depressions on the cheeks, with tethering bands still visible when the skin is stretched. Typically requires subcision combined with laser/RF microneedling.

3

Severe — deeply tethered, mixed with other scar types

The base is firmly anchored to deeper tissues, interspersed with boxcar and icepick scars. Requires a multi-step, multi-session treatment plan with the expectation of gradual improvement.

When should you see a doctor?

  • Waviness on the cheeks becomes more noticeable when smiling or viewed from an angle — an evaluation is needed to determine the presence of fibrous tethering bands.
  • You have undergone several laser sessions, but the broad depressed areas remain unchanged — the root cause may be unreleased fibrous bands.
  • The skin around the scars is thin, with visible blood vessels or post-inflammatory hyperpigmentation from previous procedures.
  • You are considering dermal fillers for your scars — a physician’s assessment is essential, as fillers are not suitable for all scar types.

How BonBoz treats it

Subcision

Releasing underlying fibrous bands to free the scar base — an essential step for rolling scars.

Learn about this method →

Fractional CO2 Laser

Resurfacing the skin and stimulating collagen production after the scar base has been released.

Learn about this method →

Microneedling RF

Stimulating deeper skin layers, ideal for tethered scars and skin prone to hyperpigmentation.

Learn about this method →

PRP for Recovery Support

Utilizing your own platelet-rich plasma alongside treatment to support post-procedure skin healing.

Learn about this method →

Cost guidance

The cost includes subcision (charged by area) combined with laser/RF microneedling sessions. The doctor will provide the estimated total cost for the treatment plan following your consultation; a reference price range is available in our cost estimator tool.

The final price follows the doctor’s recommendation after an in-person exam. A confirmed quote has no hidden extras.

Chân dung BS.Ths.CKI Kim Kha

BS.Ths.CKI Kim Kha

Aesthetic Dermatology

  • Graduated as a General Practitioner — Tay Nguyen University (2018)
  • Specialist Level I in Dermatology — Pham Ngoc Thach University of Medicine, degree awarded in 2025
  • Medical Practicing Certificate No. 009784/ĐL-CCHN — Issued by the Department of Health of Dak Lak Province on 15/10/2021
  • Over 8 years of experience in aesthetic dermatology practice (since 2018), including over 4 years of practice with an official Medical Practicing Certificate
  • Primary Specialization in Plastic and Reconstructive Surgery; Certificates in Dermatological Procedures & Minor Surgery, Microsurgery, and Lasers & Light Therapies in Dermatology
  • Certificates in Dermal Fillers, Botox, and Thread Lifts; Certificates in Emergency Resuscitation and Infection Control
  • Formerly practiced at the Aesthetic Dermatology Unit — Post and Telecommunications General Hospital (2019–2021) and Venus Sunrise Clinic (2022–2024) before joining BonBoz Clinic (2025)
  • Former lecturer in Aesthetic Dermatology Theory at Ana Aesthetic Training School (2018–2019)
  • Over 5,000 clinical dermatology cases treated
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Frequently asked questions

Is scar subcision painful?

The procedure is performed under local anesthesia, so during the treatment, you will mainly feel a sensation of pressure and tightness. Afterwards, bruising and mild tenderness may persist for a few days; the doctor will provide aftercare instructions to minimize discomfort.

How long does bruising last after subcision?

Typically 5–10 days, depending on individual healing responses and the treated area. Applying cold compresses and avoiding vigorous rubbing will help the bruising resolve faster.

Can I only undergo laser treatment without subcision?

For superficial rolling scars, this may be possible. For scars tethered by fibrous bands, laser treatment alone usually yields minimal improvement because the root cause lies beneath the skin — the doctor will evaluate this by stretching the skin.

How many subcision sessions are enough?

Usually 1–3 sessions spaced several weeks apart for a specific area, depending on the severity of the tethering. The doctor will assess the results after each session before deciding whether to proceed further.

Is it advisable to inject fillers into atrophic acne scars?

Dermal fillers can temporarily elevate certain rolling scars after subcision, but this is a temporary solution and not suitable for all scar types. This is a clinical decision made by the doctor following an examination.

Do rolling scars improve naturally with age?

On the contrary: as the skin loses collagen with age, rolling scars often become more pronounced. There is no natural mechanism for them to fill in on their own.

What should be avoided after the procedure?

Strict sun protection is required; avoid picking at scabs, using harsh exfoliating products for 1–2 weeks, and refrain from saunas or strenuous exercise during the first few days. The doctor will provide detailed, step-by-step instructions.

Can thin skin undergo subcision?

A medical evaluation by a doctor is required. Thin, highly vascular skin carries an increased risk of bruising and contour irregularities; in some cases, the doctor may opt for alternative methods.

How long does the treatment plan take?

Typically several months, as each step requires recovery time and collagen takes weeks to remodel and form. The total number of sessions depends on scar severity; the doctor will provide an estimated timeline after the consultation.

Who performs the subcision procedure at BonBoz?

A Dermatologist directly performs the procedure — as this is a subdermal invasive intervention, it is never delegated to technicians.

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