Laser Tattoo Removal for Lips?

Dear Marciajones from Melbourne, FL:
As a plastic surgeon I have seen numerous patients over the years that have had laser tattoo removal with less than optimal results. These patients then come to me, or one of my collegues, for a direct surgical excison of the laser treated area.
My main concern in this procedure for such a delicate area is that I have seen a certain degree of unpredictabilty and would be worried that you may end up with a more complex problem. Sometimes the area that is treated results in a thick scar, otherwise known as "hypertrophic scaring".
My main concern in your case would be the potential development of scaring to the lip area. This would then be very difficult to correct. I would thus strongly suggest to ask alot of questions before you decide to proceed.

There is always a potential for hypertrophic scarring from tattoo laser removal and I advise a spot test prior to treat the entire lip line with tattoo laser removal. Sometimes, surgical removal by a plastic surgeon may be preferable as the scar tissues can be hidden nicely along vermilion lip borders.

The difficulty in treating permanent make up ink vs. traditional tattoo ink is two fold.  First, the location of the ink is quite different and more challenging than most tattoos.  Secondly, make up ink has different pigment and base pigments.  Generally, the permanent make up is treatable with lasers, but the challenge is having the correct technology/wavelength if and when the color fades or degrades to another color that the laser cannot treat any longer.  Most research will support that the Q-Switched Alexandrite may be the best option.

For those areas that are unresponsive to Q-switched lasers, a recent laser conference suggested that the Sicton ProFractional ablative laser was able to offer an effective option by using a small spot size.

Lasers often provide an excellent result in removal of permanent lipliner tattooing, if the color is a dark or black color. The Alexandrite, Neodynium Yag, and Q-switched Ruby lasers can all do the job. On a few occasions, there is a paradoxical darkening that occurs with the color of the tattoo, depending on the color, especially if it is red. This would then require many regular treatments to get through this phase. No guarantee can be given, though, that the color will lighten or go away completely. The treatment is fast and often done with a numbing cream only, although an anesthetic can be injected to make it less uncomfortable depending on your symptoms.

Laser resurfacing is not indicated for permanent makeup removal, however as a side effect it can lighten it. Please consult a certified laser technician with experience treating permanent makeup around the mouth for a treatment plan that fits you and your concerns.

Make sure the laser is a Q-switched laser. IPL's are sometimes used and lead to major scarring.

With a Q-switched laser such as VersaPulse or Medlite, red ink would be expected to darken with the first treatment. Don't worry, With subsequents treatments the darkened pigment will go away.

You have to be careful trying to remove lip liner tattoo. First off, realize that there is a difference between the lasers used for skin resurfacing vs. those used for tattoo removal. A laser is a device that delivers a single wavelength of light. They get very complicated regarding how much energy is delivered, how fast, it if is pulsed, etc. The simple way to look at medical lasers is by the color of light delivered. If the color "matches" something that it hits, heat is delivered into that object. In the case of resurfacing lasers, the laser’s (CO2, erbium) wavelength matches water. Since we are made up of about 85% water, these lasers immediately vaporize the top layer of skin, and can be used for resurfacing.
In the case of tattoo removal, the tattoo ink is made up of colored particles. If you have a laser that matches the ink color, it will heat up those particles, and either vaporize them or break them into smaller particles. After multiple treatments, the particles become smaller and smaller, and may eventually go away.
There are several problems in laser tattoo removal. First, not all tattoo inks are pure colors. They may be a mix of different pigments. The laser may get rid of part of the ink, but you might be forced to switch to a different wavelength to remove the other pigment. Second, although laser technology has rapidly been improving, a side effect of the treatment is that some heat is delivered into the tissues around the ink. This heat can cause scarring, but more importantly for the lips, it might cause coagulation of some of the small lip capillaries that give your lips the red color. (ie: The naturally red component of your lip may turn white.) Finally, some red tattoo pigments (made of ferric oxide particles), can change to black ferrus oxide when exposed to lasers.
With all this in mind, if you want to try using a "tattoo" laser to remove your lip liner, go to someone with experience in performing this procedure, and consider using a test spot. It is better to go back for several sessions, slowly increasing the intensity, rather than "go for broke" and try to do it all at once. If you try to remove it all in one session, you'd be running the risk of scarring, depigmenting, or even possibly having a black outline.