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Ankle Tattoo - Nashville, TN

I have been following these blogs for about a year...

I have been following these blogs for about a year. I've learned more about this procedure from this community than from any online research or doctor consultations. So, I guess it is time to share my story. I got my tattoo when I was 18. I thought it was a good idea. It was a 2" dove with purple flowers and green leaves encircling my ankle. I don't have any good pictures of it. Sorry. Fast forward 23 years and I am completely over it. I did some research and decided to pursue laser removal. I scheduled a consultation with a Medical Aesthetician. First red flag: no doctor consulted or evaluated me. She charged me $99 and said it could be completely removed in 3-5 treatments. Second red flag: old tattoos, and those located on the ankle, and very difficult to remove and often require many treatments. The first treatment was completed on 11/28/12. It was painful, but tolerable. She scheduled my next treatment in 3 weeks. Third red flag: the minimum wait time between treatments should be 6 weeks, preferably 8+ weeks.
I will continue to chronicle my experience in the hope that others will benefit from my story.

Second treatment 12/19/12

My second treatment was with the same Medical Aesthetician. I forgot to mention that at this clinic they were using an Alex and a Yag laser. She recommended we increase the laser strength. As she began to zap it, a bright green light came from the laser and lit up the room. She was surprised and pulled out 2 pairs of dark glasses. She put a pair on and suggested I do the same. Red flags 4, 5, & 6: the technician should not be surprised by what the laser does, if she is, she should consult with a doctor, and everyone in the room should always wear protective glasses. This treatment was significantly more painful. She bandaged my ankle and scheduled my next appointment for 3 weeks. (See red flag number 3.) My entire tattoo blistered within hours of the laser, and my leg felt like it was on fire. My ankle and foot were swollen for a week and it took ten days for the blisters to go away. I was scabbed for an additional 2 weeks. I called the clinic to reschedule my third treatment as my skin was not intact and needed more healing time.

Third treatment 3/6/13

I arrived for the third treatment and the Medical Aesthetician told me that it was her last day on the job and she was going to another clinic. She said I should continue my treatments with one of the doctors at the clinic. She said she was going to use the same laser settings as the 2nd treatment, but they were definitely lower. She did not charge me for the treatment because "she felt badly that I would have to continue with a new provider". I had no blistering and minimal scabbing. Fast forward 13 months and I see the Medical Aesthetician at the same clinic every time I go there. She doesn't acknowledge me when she sees me in the waiting room.

Fourth Treatment 4/10/13

On my 4th appointment I met with a doctor that examined my tattoo and told me she was not sure it could be completely removed. I had developed some scar tissue (likely from tx #2) that inhibits the laser's ability to reach the underlying ink. Even without the scar tissue, green ink on the ankle is nearly impossible to remove. Bummer. Had I known that from the onset, I would likely never have started this process. Her RN performed the treatment. It was certainly painful, but nowhere nearly as bad as the 2nd treatment. She gave me samples of Alcortin-A and Locoid. I highly recommend both medications! The Alcortin-A is an antibiotic with hydrocortisone that I use following a treatment while it is still healing. It minimizes the itching. The Locoid is a hydrocortisone I use once the scabs are gone. I scheduled my next treatment for 8 weeks.

Fifth & Sixth Treatments, 5/22/13 & 7/15/13

At theses appointmenst, I did not see the doctor. The RN treated my tattoo at the same laser settings (Alex laser: 3 jules, 3mm spot, Yag 1064: 5 jules, 3mm spot). The aftercare was becoming routine: Alcortin-A, Locoid, Aquaphor, and lots of gauze and coban. It was not fading much and the RN agreed it was not progressing well. I forget to mention that when I began seeing the MD/RN, the price went from $99 to $250. I was fatigued of the whole process and regretting the undertaking. I started researching the Picosure laser, but the closest one was 5 hours away.

Seventh Treatment 9/4/13

I met with the doctor at this appointment. I was not only disappointed with the lack of fading, but now I was getting significant hyperpigmentation. She recommended we lower the laser settings this time and wait at least 10 weeks before my next treatment. She also prescribed Hydroquinone and Tazorac creams for the hyperpigmentation. In a couple weeks, once the skin was healed, I began using the creams. It was horrible! For the 6 weeks that I used the creams, my tattoo and the surrounding skin was bright red and tender. I gave up on them and the redness subsided. A couple months later, the hyperpigmentation faded on its own. I found a clinic with a Picosure laser that was 2 hours away and scheduled an appointment.

Between 6th & 7th Treatments

Original Tattoo

I zoomed in on a couple pictures of my tattoo prior to any lasers. They are not very good, but at least you can see how dark it was.

Eighth Treatment 2/11/14

After a 22 week break, I drove 2 hours to the nearest clinic with a Picosure laser. The doctor evaluated my ankle. He said the scar tissue would hinder my progress, but he thought he could clear most of the ink in 3-5 treatments with only shadows of ink remaining. The cost was $350. The laser was not any more or less painful than the others (except #2). At the previous clinic, I needed 2 passes with the laser to address the different colors. I only needed 1 pass with the Picosure since it targeted the black, purple, and green. I iced may ankle on the car ride home, which I have found minimizes some of the swelling. The aftercare wasn't any different than previous treatments (except for #2). It has been almost 11 weeks since the treatment and I have seen significant fading. More so with the Picosure than any of the previous. I am finally feeling hopeful about this process.

More Pics After Picosure #1

Ninth Treatment 5/16/14

I had my second treatment done 13 weeks after the first. The settings were turned up and it stung quite a bit more. I really don't know how those of you with large tattoos are doing this! With the q-switch laser I always had pinpoint bleeding, blisters, swelling, and scabs. With the Picosure, I have had none. At first I was concerned that it was not going to be effective. I've been so pleased with the results, though. It is now 2 days after the treatment and my skin is completely intact. It feels like a minor sunburn. I'm hoping to get as much fading as I did last time.

Three Weeks Post Treatment

My ninth treatment (2nd Picosure) was 23 days ago. There have been no issues with healing and I only needed to bandage it for a couple days. It was hyper-pigmented for awhile, but that has faded a lot in the last 2 days. Strangely, the color changes throughout the day. Sometimes it looks like all the colors are fading nicely. When I'm cold, the whole tattoo is dark purple. After a shower, it is bright red. It's like having a mood ring attached to my ankle! I've uploaded several pictures that were all taken today, so you can see how much it varies. I'm hopeful it will continue to fade and I won't need more than a couple of treatments.

Eight Weeks Post Treatment

I'm 8 weeks out from my 2nd Picosure treatment, 9th treatment overall. It's difficult to get good pictures of my tattoo, but I'm posting some taken in natural light. Overall I am happy with the fading. It still this strange "mood ring" thing where it turns bright red after a shower and dark purple when I'm cold. So here is the good, the bad, and the ugly: the thin black lines that outlined the leaves, vines, and flowers are completely gone, and the thin green vines are almost gone (the good); some of the purple flowers are fading significantly, some are scarred and not fading as well (the bad); the left half of the dove is fading nicely, while the right half is not (the ugly). Does that make any sense?!?
This is certainly an exercise in patience. I hope to achieve complete removal. I am very happy with the Picosure and my overall fading. Though I know I have made a lot of progress, I still get frustrated and impatient. I plan to wait another 4 weeks before my next treatment.

Tenth treatment 10/13/14

I ended up waiting 21 weeks before this treatment. The process gets to be fatiguing and I just wanted to forget about it and enjoy the summer. I really like the clinic I've been going to. The Picosure laser is completely worth the cost and the 2 1/2 hour drive. They recently installed the Boost update. As explained to me, it delivers increased pressure into a smaller spot size, and is supposed to be especially effective on tattoos that have already faded a lot. It wasn't any more or less painful than previous treatments. I could feel that it was a smaller spot size. I didn't take any pictures before my appointment, but I will post some from 6 weeks ago.
Dr. Lappert

This review section will not allow me to change the "location" field. I live in Nashville, but Dr. Lappert is located in Huntsville, Alabama. I have been very impressed with him and his staff. They are very patient and supportive.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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