Combination Therapy for Hypotrophic Rolling Scars

Hypotrophic rolling scars pose a treatment challenge due to their elevated nature and wavy texture. A multimodal approach can offer improved outcomes. This case study reviews the efficacy of Fotona Cold Fractional Laser combined with subcision and BellaFill injections for acne scars treatment.

Patient Profile:

  • Age: 45
  • Gender: Female
  • Skin type: Sensitive with a history of acne scarring
  • Primary concern: Hypotrophic rolling scars around the cheek and eye region

Pre-Treatment Assessment:

The patient exhibited multiple hypotrophic rolling scars. These scars were raised with a characteristic wavy texture, primarily located on the cheek near the eye.

Treatment Plan:

A comprehensive three-tiered approach was implemented:

  1. Fotona Cold Fractional Laser: For skin texture enhancement and collagen stimulation.
  2. Subcision: For breaking the fibrotic strands beneath the scars and leveling the skin.
  3. BellaFill Injections: To provide volume post-subcision and create a smoother skin profile.


  1. Fotona Cold Fractional Laser: The patient received four sessions at intervals of 4-6 weeks.
  2. Subcision: After the laser treatments, subcision was administered to the scars. This procedure involved using a needle to sever the fibrotic strands anchoring the skin.
  3. BellaFill Injections: Post-subcision, BellaFill, a dermal filler, was introduced to uphold the elevation attained from subcision and offer a lasting, even appearance.


Post-treatment images highlight a marked reduction in hypotrophic rolling scars. The skin is smoother, and the elevated scars have been noticeably flattened, resulting in a more consistent skin tone. The combined therapies yielded both instant and sustained results, improving the patient’s self-image.


The combination of Fotona Cold Fractional Laser, subcision, and BellaFill injections effectively treated hypotrophic rolling scars in this instance. The multi-pronged strategy addressed the scar’s texture and elevation, providing a comprehensive remedy. This study underscores the benefits of using synergistic treatments for optimal scar reduction.

Fat Reduction

Rolling Scars

Acne Scar Types and Classifications

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Before and after TCA peel treatment reducing the appearance of acne scars.
Before subcision treatment for deep acne scars after subcision treatment for deep acne scars

This case study is based on the personal experience of one patient and is not intended to represent typical results. Individual results may vary, and the treatment results depicted in this case study are not guaranteed. The information provided in this case study is not a substitute for a consultation with a licensed healthcare provider, and it is important to understand that results vary from person to person. Before undergoing any cosmetic treatment, it is important to speak with a licensed healthcare provider to understand the potential risks, benefits, and results.