This innovation was developed in Korea, which I discovered while visiting a famous clinic there. The Intradermal Air Dissection machine literally separates the skin layer with air. In fact, the machine helps to remove the fibrosis using high-pressured air. 

    Before understanding how the machine works, it is important to understand how the skin fixes itself. 

    The nature of human skin (excluding the fat layer) comprises of a thin layer called the epidermis. Under this layer is the true skin or dermis layer. There are many types of cells in this area including blood vessels, nerves, pores, and hair follicles collectively known as adnexal structure. The most important area in this structure is the basal cell layer, where cells can regrow new skin similar with a mechanism similar to that of stem cells.

    The basal layer is surrounded by pores. It is buried in the thin layer between the dermis and epidermis. This basal layer plays a major role in the scaring of skin. If a wound does not destroy the basal layer, there would be no scaring because the skin can regrow and fix itself. Deeper cuts or incisions such as operation or liposuction poorly done that affect the layers of fat cause fibrosis, which can appear on the skin or under it. The fibrosis visible on the skin is scarring. The scar may form a bump or a cleft on the skin. The fibrosis under the skin is not generally visible but can be felt. The area would be harder and less smooth and supple compared to regular skin. This may result in deep clefts in the skin. Fibrosis is similar in structure to tendons holding the skin layers together. Sunken skin between the eyebrows or so called Glabella may fold in causing reduction in oxygen. If left untreated for a long time the result will be a permanent appearance of a static line. 

    From the knowledge discussed in the previous section, some aesthetic procedures have been thus innovated. For example, the facial thread lifting, this procedure may require the use of hundred of threads meaning hundred of needles penetrating the skin. However, there would be no scaring because the needles are very small and not much damage is done to the basal cell layer. If the threads are well placed with minimum damages, there would be no development of fibrosis under the skin. When patients ask if facial thread lift procedures would causing scaring and fibrosis, the answer is yes and no depending on the technique of the doctor. Another example of treatment that applies this knowledge is the Fractional Laser, which creates small needle-like punctures in the skin to stimulate new skin growth without causing damage and scaring.

    Treating Scars, Skin Craters, Large Pores, and Stimulating New Skin Growth

    The principle of the treatment is simple. If the fibrosis under the skin were removed, the skin would raise up. It is the same idea as using a needle to remove the fibrosis before injecting filler. The only difference is this machine targets the dermis directly. In the past doctors have utilized procedures that attempt to remove fibrosis. They usually used big sharp needles in a procedure called subcision. However, it is not very effective because if small needles are used the entire area may not be treated sufficiently. In the case that big needles are used the skin may be damaged further causing more fibrosis to form later.

    Illustration of traditional subcision technique

    Intradermal air dissector machine

    Demonstration of treatment using intradermal air dissection By Dr. Puttipong poomsuwan in korea

    The Intradermal Air Dissector uses high-speed high-pressure air to remove fibrosis under the skin. The needles used are sized 31G, which is very small. This ensures that the skin would not be damaged. The skin layer that is separated would start to regrow, which is a similar mechanism to the regrowth of skin when wounded. This would be especially more effective if a special stem cell serum is injected to stimulate the skin growth. The end result is the gradual disappearance of scars and craters. In addition the pores will get smaller with new skin surfacing resulting in a younger refreshed look.