I have a 1" by 1" tattoo on lower ankle that I would like to get removed. I have my first laser treatment today and was told that they can't guarantee it will be completely removed. She said in some cases lasers just fade the tattoo. Well I want complete removal so thought maybe I should just save my money and do an excision. I'd rather have a scar than a faded tattoo. But where do I look for a doctor that will do this?
What Type of Doctor to Get a Tattoo Excision?
Doctor Answers 5
Based on your description of the tattoo you need to be very careful. A one by one inch tattoo on the lower ankle may require at least 2 operations to remove (staged excision). There is very little skin laxity in this area making excision relatively risky. Also, the skin in this area can be quite thin. The lower extremity is notorious for potential wound healing problems (related to blood flow and venous drainage). You will need to stay off your feet for at least one week.
I would think twice, if I were you, about excision given the considerations discussed above. Laser treatment may be in your best interest, everything considered.
If you do decide to have it excised I would strongly suggest choosing a well experienced/board-certified plastic surgeon.
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Your best options are a good Dermatologic Surgeon or Plastic Surgeon. Make sure the physician you choose is experienced in excisional skin surgery. For example, while most excisional skin cancer surgery in the US is performed by Dermatologist, some prefer to refer these patients out.
Who does tattoo excisions
If you really don't want to try laser tattoo treatment, even though it may provide a wonderful result, you can see a plastic or dermatologic surgeon. The scar from surgery near the ankle can be horendous, though. It can open, get infected, or spread over time.
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The downside of any surgery on the ankle is the quality and length of the resulting scar. As you can readily check for yourself, the ankle is relatively skin tight. In other words, we do not have a lot of loose skin there which would permit a large excision and still allow skin closure without tension. As a result you may require SERIAL EXCISION (the removal of a portion of the lesion at a time with a few months intervening periods to allow the skin to loosen and enable another excision until the whole tattoo is removed).
Another option is to do a flap - borrow a segment of tissue next door, where the flesh is looser and transfer it by rotation to cover the area of the hole left by removing the tattoo. The problem here would be extensive scarring which in my opinion are MUCH worse than several laser treatments and a partially faded tattoo.
While laser treatment may be expensive, surgical treatment(s) are far from cheap. You would need to consider all your options carefully.
I good plastic surgeon would be the one I would chose. The lower leg can be a difficult place for surgery, so chose your plastic surgeon carefully. Many of the plastic surgeons on this site have offered excellent advice on how to chose a good plastic surgeon so I would avail yourself of this resource.
If your tattoo is multi-colored and professionally done, therefore requiring more treatments, you might be surprised that the surgical excision is less costly than the laser tattoo removal option.