Do Any of These Concerns Sound Familiar?
- Acne scar craters that haven’t improved in years
- Multiple sessions of Dermapen Microneedling with little noticeable change
- Indentations that remain even after fractional laser treatment
- Being told by another clinic that “further improvement is difficult”
- Feeling self-conscious about uneven skin texture
These concerns may be addressed with CO2 Laser + Subcision.
What Is CO2 Laser + Subcision?
By combining CO2 laser with subcision, this treatment can target deep crater scars that have been difficult to address with conventional approaches.
How the Treatment Works
STEP 1
Smoothing Crater Edges with CO2 Laser
The sharp, angular edges surrounding the indentation are vaporized with CO2 laser, reshaping them into a gentler contour. This promotes more uniform light reflection, making the unevenness less noticeable.
STEP 2
Releasing Adherent Scar Tissue with Subcision
Abnormal scar tissue that has become fibrotic beneath the skin—pulling the surface downward—is cut and released using a specialized needle. This frees the base of the indentation, allowing the skin to rise.
STEP 3
Shallower Indentation and Smoother Skin
Surface smoothing by the laser and deep release by subcision work together synergistically. As collagen regeneration progresses after treatment, further improvement in the indentation can be expected.
OPTION: Hyaluronic Acid Injection
Following subcision, hyaluronic acid may be injected to help prevent re-adhesion of scar tissue. The hyaluronic acid acts as a spacer, supporting more consistent improvement of the indentation.
Three Types of Acne Scar Craters
Crater scars fall into three main types, each of which responds best to different treatment approaches. Our clinic offers tailored treatment plans for all three types.
01 Rolling Type
Size: 5 mm – 1 cm in diameter
Gently sloping, rounded indentations caused by abnormal fibrous tissue beneath the skin pulling the surface downward.
Recommended treatment: Subcision to release adhesions + Hyaluronic acid to fill and lift
02 Boxcar Type
Size: Varies (shallow to deep)
Indentations with vertical walls and a flat base, resulting from skin tissue loss due to inflammation and abnormal collagen deposition.
Recommended treatment: CO2 Laser to smooth the edges + Subcision to lift the base
03 Ice Pick Type
Size: 2 mm or less in diameter
Small but deep, needle-like indentations that extend into the subcutaneous tissue, caused by fibrosis progressing along the hair follicle due to prolonged inflammation.
Recommended treatment: CO2 Laser to widen the opening + Subcision as needed
6 Reasons to Choose IC Clinic
Crater Scar Treatment by Board-Certified Plastic Surgeons
Our 18 board-certified plastic surgeons accurately assess your crater type and propose a treatment plan tailored to your individual condition.
Combined Treatment: CO2 Laser + Subcision
By approaching both the surface and deeper layers simultaneously, this combined treatment can address deep crater scars where single-modality treatment has shown limited results.
Treatment Available for All 3 Crater Types
We provide care for rolling, boxcar, and ice pick crater types. Individual treatment plans are also developed for cases involving a combination of types.
Transparent, Honest Pricing
Consultations, initial exam fees, and follow-up exam fees are all complimentary. Treatment costs are communicated in advance, with no hidden charges.
Network of 6 Clinics in the Tokyo Area
With locations in Shinjuku, Shibuya, Ueno, Ikebukuro, Tokyo, and Omiya, you can choose the clinic most convenient for you.
3-Minute Walk from Shinjuku Station South Exit
Conveniently located just 3 minutes on foot from the South Exit of JR Shinjuku Station. The clinic is open on weekends and public holidays, making it easy to visit after work or on days off.
Comparison with Other Treatments
Dermapen Microneedling and fractional laser are effective for shallow acne scars, but for deep crater scars, CO2 Laser + Subcision offers a more targeted option.
| CO2 Laser + Subcision | Dermapen Microneedling | Fractional Laser | |
|---|---|---|---|
| Deep craters | ◎ | △ | △ |
| Shallow acne scars | ○ | ◎ | ◎ |
| Rolling type | ◎ | △ | △ |
| Ice pick type | ◎ | × | △ |
| Sessions required (estimate) | 1–3 | 5–10 | 5–10 |
| Downtime | 1–10 days | 3–7 days | 3–7 days |
※ Results vary among individuals. The most suitable treatment will be recommended during your consultation.
Case Studies
Case 1: Female in her 40s / Boxcar + Rolling Type / Both Cheeks
CO2 Laser + Subcision — 2 sessions
[Side effects / Risks] Bruising, swelling, scabbing, redness (lasting several weeks to several months), possible post-inflammatory hyperpigmentation
Case 2: Male in his 30s / Ice Pick Type / Both Cheeks
CO2 Laser + Subcision — 3 sessions
[Side effects / Risks] Bruising, swelling, scabbing, redness (lasting several weeks to several months), possible post-inflammatory hyperpigmentation
Treatment Process
① Book an Appointment
Please make a reservation via our online booking form or by phone.
② Consultation and Examination
A board-certified plastic surgeon will assess your crater type and propose a tailored treatment plan. Consultation is complimentary.
③ Treatment
After local anesthesia is administered, the CO2 laser and subcision procedures are performed. Treatment time is approximately 30 minutes to 1 hour, depending on the area treated.
④ Aftercare
We monitor your progress after treatment and discuss any additional care as needed. Follow-up visits are complimentary.
Pricing
| Treatment | Price (tax included) |
|---|---|
| Subcision — 1×1 cm | ¥9,800 |
| Subcision — 2×2 cm | ¥22,000 |
| Additional CO2 Laser (optional) — 2×2 cm | ¥22,000 |
| Hyaluronic Acid Injection (optional) — 2×2 cm | ¥22,000 |
※ Pricing varies depending on the extent and severity of the condition. An accurate estimate will be provided during your complimentary consultation.
Zero-Cost Guarantee
The following are all complimentary:
- Consultation / Initial exam fee
- Follow-up exam fee
- Appointment cancellation fee
- Aftercare
Payment Methods
Cash / Credit card / Debit card / Medical financing
VISA / Mastercard / JCB / AMEX
Frequently Asked Questions
What types of crater scars can CO2 Laser + Subcision address?
This treatment can be applied to all three crater types: rolling, boxcar, and ice pick. It may be particularly helpful for deep indentations and tethered craters that have shown limited improvement with Dermapen Microneedling or fractional laser. Results vary among individuals.
How many treatment sessions are typically needed?
This depends on the severity of your condition, but a general guideline is 1–3 sessions per area. Treatment intervals are typically 1–3 months apart, with a total treatment period of approximately 3–12 months. A more specific recommendation will be made during your consultation.
What is the expected downtime?
Downtime varies depending on the treatment area and the individual, but is generally around 1–10 days. Redness, swelling, and scabbing may occur after treatment, but these gradually subside. Bruising may also appear in some cases and typically fades within 1–2 weeks.
Is the treatment painful?
Local anesthesia is used to minimize discomfort during the procedure. Some mild pain or discomfort may be felt once the anesthesia wears off, which can typically be managed with over-the-counter pain relief.
Dermapen Microneedling didn’t work for me — could this treatment help?
Dermapen Microneedling primarily targets the superficial layers of the skin, which means it may provide limited improvement for deep craters or tethered scars caused by subcutaneous adhesions. Since CO2 Laser + Subcision can reach deeper layers, it may offer improvement for craters that did not respond to Dermapen. Results vary among individuals.
What are the possible side effects and risks?
Possible side effects include bruising, swelling, scabbing, redness (lasting several weeks to several months), temporary post-inflammatory hyperpigmentation, and firmness in the treated area. Please note that not all craters will fully disappear, and the degree of improvement varies among individuals. Full details will be explained during your consultation.
Is there a minimum age requirement for treatment?
Treatment is available for minors with parental or guardian consent. We generally recommend waiting until active acne has fully settled before undergoing crater scar treatment. Please feel free to discuss this during your consultation.
