Med Lasers.  2023 Jun;12(2):116-121. 10.25289/ML.23.018.

Utility of the stacking method for depressed scar improvement using a 1,064-nm, microlens array, picosecond-dominant laser in Republic of Korea: retrospective clinical study

• Kim YJ
• Cha HG
• Park ES

• KMID: 2551142
• DOI: http://doi.org/10.25289/ML.23.018

Abstract

Background
The depression type of scars is the most complex problem that a plastic surgeon confronts. Traditionally, many plastic surgeons use the subcision technique for sunken scars to release scar tissue. The mechanism of the subcision technique involves cutting the contracted collagen beneath the pitted scar. The laser-induced optical breakdown effect induced by a fractional picosecond laser could produce vacuoles under the depressed scars in the epidermal and dermal layers, which is similar to the mechanism of subcision. This study investigated the efficacy and safety of a 1,064-nm fractional picosecond laser treatment for depressed scars using a stacking method.
Methods
The patients’ medical charts and procedure records were reviewed retrospectively to evaluate the outcomes and complications after the procedures. The patients were treated with a 1,064-nm fractional picosecond laser at 4-week intervals with a spot size of 3 mm, fluence of 1.5 to 5.5 J/cm² , and frequency of 10 Hz with a combination of microlens arrays.
Results
Fifteen and sixteen patients were male and female, respectively. The mean modified Vancouver Scar Scale for the treated scars was 7.75 ± 1.07 points before treatment, which decreased to 4.66 ± 0.87 points one month after the final treatment. The mean patients’ satisfaction scores were 2.11 ± 0.52 before treatment and 4.20 ± 0.72 one month after picosecond laser treatment.
Conclusion
The stacking method can cause cavitation at the deep dermis, and cavitation stimulates collagen and elastic fibers. As cavitation is formed, the recovery period is shortened, and the effects of depressed scar treatment are very satisfactory.

Keyword

Lasers; Stacking method; Depressed scar