Medical Treatments · Skin & Lasers · IN Eternity Clinic
4D Scar Reconstruction in Singapore
A combined acne scar protocol that treats each scar by what is actually wrong with it: a pitted surface, a tethered base, a narrow deep track or lost volume. Different scars, different tools, one plan.
Written & medically reviewed by Dr Sin Yong · 8 October 2026
Quick answer
- A combined acne scar protocol that treats each scar by what is actually wrong with it: a pitted surface, a tethered base, a narrow deep track or lost volume. Different scars, different tools, one plan.
- Performed by: Dr Sin Yong at IN Eternity Clinic, 9 Scotts Road, Pacific Plaza (beside Orchard MRT).
- Enquire: SkinRev Lab, CityLink Mall (City Hall MRT) passes enquiries to the clinic, or contact IN Eternity Clinic directly on +65 8815 3008.
- Suitability, number of sessions and pricing are decided at consultation; individual results vary.
4D Scar Reconstruction is IN Eternity Clinic's combined protocol for depressed acne scars, planned and performed by Dr Sin Yong. For people looking into 4D scar reconstruction in Singapore, the idea is simple: most faces with acne scarring have a mix of scar types, and no single device treats them all well. So instead of one machine applied evenly, each scar is assessed and matched to the method that addresses its structure.
The four tools are subcision, which releases scars tied down by fibrous bands; TCA CROSS, a focused chemical method for narrow, deep scars; fractional CO₂ laser using the DEKA Tetra Pro S3 approach, for the surface and edges; and, where volume has been lost, an injectable to support the scar floor. Not every patient needs all four. Leftover redness or brown marks after acne can be addressed separately with a pigment laser.
How it works
The mechanism,
in plain English
Atrophic acne scars are usually grouped into three types. Rolling scars are broad, soft depressions pulled down by fibrous bands under the skin; subcision uses a fine needle or cannula, under local anaesthetic, to cut these bands so the skin can rise and new collagen can fill the space. Icepick and narrow boxcar scars are deep, narrow tracks that lasers often struggle to reach; TCA CROSS places a high-strength trichloroacetic acid solution precisely into each scar to trigger collagen inside it.
Fractional CO₂ laser then works on the surface: targeted point-shots soften the sharp edges and floors of individual scars, and a fractional pass over the surrounding skin blends texture. Where deeper volume has been lost after subcision, a filler or collagen-stimulating injectable can be placed under the released scar to support it. Sequencing matters, so subcision is done before laser, and treatments are spaced to let the skin heal and remodel. Improvement continues for months after the last session.
“Acne scars are not one problem, so they rarely respond to one machine; the plan has to follow the scar.”
— Dr Sin Yong, IN Eternity Clinic
- Energy / product
- Subcision, TCA CROSS (trichloroacetic acid), DEKA Tetra Pro fractional CO₂ laser (10,600 nm), and filler where needed
- Target layer
- Surface and edges (laser), dermis (TCA CROSS, laser), subcutaneous bands (subcision), volume (injectable)
- Typical session
- Varies with the methods used, after 45–60 minutes of numbing cream
- Downtime
- About a week of crusting; bruising from subcision can take up to two weeks to fade
- Performed by
- Dr Sin Yong, IN Eternity Clinic
Is it right for you
Who it suits,
and who it does not
4D scar reconstruction in Singapore suits adults whose acne is controlled and who have a mix of depressed scars: rolling scars that look like shadows in side lighting, boxcar scars with defined edges, and icepick scars that look like deep pores. It is meant for people who have tried, or are considering, single treatments and want a structured plan, and who can take about one to two weeks of social downtime after each session.
It is not for people with active acne, which should be treated and controlled first, or for raised hypertrophic scars and keloids, which are planned differently. People who have recently taken certain oral acne medicines may need to wait, and timing is reviewed individually. Pregnancy, active infection or cold sores, bleeding disorders, a strong tendency to keloids, and a fresh tan are reasons to delay. People who darken easily after skin injury need extra preparation and aftercare, and sometimes gentler options first.
What to expect
Consultation, session
and aftercare
At consultation, Dr Sin Yong examines your scars under different lighting angles, maps them by type, and checks your skin type, acne control and medical history. He explains which methods each area needs, the order they will be done in, the expected downtime and realistic improvement. Exfoliating acids, scrubs and retinoids are usually stopped about a week beforehand. A course is usually planned at consultation, with sessions spaced weeks apart.
On the day, numbing cream is applied for 45 to 60 minutes and local anaesthetic is used for subcision. The skin feels hot and tight afterwards, like strong sunburn, and swelling often peaks over the first few days. Fine crusts usually flake by about a week, bruising from subcision may take up to two weeks to fade, and pinkness settles over a few weeks. Avoid picking, use the recommended ointment, protect the skin from sun, and report signs of infection promptly.
Where this happens
Assessment and non-invasive care — SkinRev Lab, CityLink Mall #B1-28, 1 Raffles Link, Singapore 039393. Underground from City Hall MRT and Esplanade MRT; a short walk from Raffles Place, Marina Bay, Suntec and Bugis. Open daily 11am–8pm.
Medical treatment — IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, Singapore 228210, beside Orchard MRT (three stops from City Hall on the North-South line). Mon–Sat 11am–8pm, closed Sunday. Treatments are performed by Dr Sin Yong. WhatsApp +65 8815 3008.
Enquiries to SkinRev Lab about medical treatments are passed to IN Eternity Clinic, where Dr Sin Yong performs them.
Clinic page: 4D Scar Reconstruction at IN Eternity Clinic ↗
What the research says
The evidence,
with sources
A widely used classification divides atrophic acne scars into icepick, rolling and boxcar types, and an updated review using that system described subcision, chemical methods, fillers, microneedling and energy-based devices as options matched to scar type, while noting that high-quality comparative studies are few. A systematic review of 89 studies concluded that fractional lasers and radiofrequency improve most atrophic scar types and can be combined with other options, and that combination therapy typically gives better outcomes than single treatments.
For individual components, the original TCA CROSS study in 65 patients with skin types IV to V reported good responses in most patients without significant complications, supporting its use for narrow, deep scars in darker skin. A 2026 network meta-analysis of 56 randomised studies of moderate-to-severe atrophic acne scars found combination therapies generally outperformed single treatments, with fractional CO₂ combined with subcision among the most consistently beneficial. Individual results vary, and scars improve rather than disappear.
References
- Boen M, Jacob C. A review and update of treatment options using the acne scar classification system. Dermatol Surg. 2019;45(3):411-422.
- Bhargava S, Cunha PR, Lee J, et al. Acne scarring management: systematic review and evaluation of the evidence. Am J Clin Dermatol. 2018;19(4):459-477.
- Lee JB, Chung WG, Kwahck H, et al. Focal treatment of acne scars with trichloroacetic acid: chemical reconstruction of skin scars method. Dermatol Surg. 2002;28(11):1017-1021.
- Ou Y, An G, Liang J, et al. Laser, microneedling, and combination therapies for moderate to severe acne atrophic scars: a systematic review and network meta-analysis. Aesthetic Plast Surg. 2026;50(17):7308-7334.
Common questions
Your questions,
answered
How much does 4D scar reconstruction in Singapore cost at IN Eternity Clinic?
Pricing is given at consultation at IN Eternity Clinic, because it depends on how many scars there are, which methods each area needs, and whether an injectable is part of the plan. Since the protocol is tailored scar by scar, a fixed price list would not be accurate. Dr Sin Yong will explain the plan, the number of sessions he expects and the downtime before you decide.
What does the 4D mean?
It refers to the four aspects of a scar the protocol addresses: the surface and edges, treated with fractional CO₂ laser; the depth of narrow scars, treated with TCA CROSS; the tethering bands underneath, released by subcision; and lost volume, supported with an injectable where needed. Each scar is matched to the aspects that apply to it, so not everyone receives all four.
Which acne scars respond to which method?
Rolling scars, which are tethered from below, respond mainly to subcision followed by laser. Icepick and narrow boxcar scars, which are deep and narrow, respond to TCA CROSS, because lasers often cannot reach the bottom. Wider boxcar scars and general texture respond to fractional CO₂, and areas with lost volume may need an injectable. Most faces have a mix.
How much downtime should I plan for?
Plan for about one to two weeks of social downtime after a session. Crusts from the laser and TCA CROSS usually flake by about a week, and bruising from subcision can take up to two weeks to fade. Pinkness then settles over a few weeks and can be covered with make-up once the skin has healed. Many people time sessions around leave.
How many sessions will my acne scars need?
It depends on the number, type and depth of scars and how your skin heals, so a course is planned at consultation. Some people need only a few combined sessions, others more, spaced weeks apart. Collagen continues to remodel for months after each session, so final improvement is judged well after the last one. Scars improve rather than disappear, and individual results vary.
Is it safe for Asian skin?
Each of these methods has been used in Asian and darker skin; TCA CROSS was first described in skin types IV to V. The main risk is temporary darkening after laser and chemical treatments, so settings are chosen to limit heat spread, skin is prepared beforehand, and sun protection afterwards is strict. These steps lower the risk but cannot remove it entirely.
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