Tattoo Removal (huge blackwork tat) could I achieve perfect removal? (photos)

Question

Hey there, is it possible to achieve a near perfect removal for the following tattoo? Pigmentation is fairly high so I guess it might take quite some time and a lot of sessions...

Harold J. Kaplan, MD · Answer

Hi Hure.  The answer is yes, we should be able to get complete removal, but you are correct that quite a number of sessions would be required.  We would estimate 8-12 treatments.

Jason Emer, MD · Answer

Tattoos should be removed with q switched or pico lasers. It will take a series of treatments for removal, but it's difficult to determine how many sessions you'll need. I recommend allowing 4-6 weeks in between treatments. This allows appropriate reabsorption of pigment and healing of any skin changes that occurred. I recommend getting a formal evaluation with a laser tattoo removal expert. Best, Dr. Emer

Joel Schlessinger, MD · Answer

Tattoos are difficult if there is significant amounts of ink and this one seems to have quite a bit.  While removal is definitely possible, there will likely be some tattoo left whatever the case.  And it will require multiple sessions that are challenging and costly.  Having said that, there is no reason not to try, but it won't be perfect.  Best wishes!

Kory Kitagawa, MD · Answer

The PicoWay laser can remove your black tattoo and can also remove red ink, thanks to its adjustable wavelengths. PicoWay uses extremely fast pulses of high energy to shatter the pigment in tattoos into pieces that are small enough for the body to process and eliminate. It takes time to remove a tattoo because the colors are removed layer by layer and the body has to process all of the shattered pigment. With patience, you should be able to remove your tattoo, but it will take at least 8 sessions. A board-certified dermatologist who is expert with the PicoWay laser will do the best job for you.

Michelle Ellern, DO · Answer

Most patients will have full removal or a shadow of ink left at the end.  You are right that it may take a good number of treatments if there are areas of highly saturated ink.  I would find an experienced physician with a Pico second laser and have an in person consultation.  Good luck with your tattoo removal.

Robert Pettis, MD · Answer

Hello and thank you for your question and providing a photo.

Our practice has been using the PicoSure laser since it received FDA approval for tattoo removal over three years ago.  The way that the PicoSure laser works, is, if you think of the ink of a tattoo as a "boulder", other lasers break the ink into "rocks", the PicoSure laser shatters the ink into "grains of sand".  These tiny particles are then eliminated by your body over time.As a medical practice, we follow traditional clinical protocols, and we recommend that you find a highly experienced practitioner that does the same.  They should start with a free consultation, take information from you to determine if you are a medically appropriate candidate for laser treatments, and take specific measurements to determine the size of the inked area (versus drawing a frame around the tattoo).  Pricing is determined primarily by the size of the tattoo.  Finally, the clinician should work with you to create a treatment plan to estimate the number of treatments they anticipate will be required, cost per treatment, and the timing.  Most tattoos take between 6-8 treatments, and treatments must be spaced at least 8 weeks apart to allow your body the time it needs to clear the shattered ink.Your tattoo appears to be very densely inked, with a red star.  The "sunset colors"  (red/yellow/orange/pink) are some of the most difficult to remove, so be sure that the practitioner that you choose has the special laser attachments to specifically treat the red.It is impossible for anyone to guarantee perfect removal-the known entity is the quality of the laser used and the skill of the clinician-the unknown is the type of ink used and how well it will respond to treatment, as well as your body's own ability to assist in the process after the laser has done its' job.  However, finding a clinician with significant training and experience with similar (in density, size and ink color) tattoo removal will increase your chances of satisfactory results.  I would expect that it would be reasonable to expect significant results, it will just take time and patience.All the best to you!

Norman N. Bein, MD, FACS, RVT · Answer

If you find an experienced medical based clinic with the latest nano and pico-second wavelengths such as the Cutera Enlighten we use.  Initially your treatment should be with a nanosecond wavelength to break up the the large black ink molecules.  The physiology of tattoo removal is, the laser breaks up the ink and your body absorbs and removes it.  At your second/third treatment, pico-second wavelengths are used.  If this is a cover up tattoo, be aware the tattoo underneath will become visible.  We advise not treating before 8 weeks to allow the skin to fully heal. Treating too often may cause the skin to thicken which reduces the penetration of the laser.  It will take a series of treatments.  Anything from 4-6 or more.  Everyone is different, and each tattoo is unique.  If you have the right technology the length of time for removal may involve fewer treatments

Mark A. Blair, MD · Answer

Hello, Thank you for your question and for including photos.  The way a laser removes unwanted ink is, it shatters the ink into tiny particles and your body absorbs those particles.  Because the body also plays a part in the removal process, it is impossible to guarantee anyone complete removal.  The latest technology in laser tattoo removal is the pico-second technology.  The PicoWay Laser (Candela/Syneron) uses photoacoustic impact/pressure waves rather than photothermal/heat.  This process has less heat, therefore it is more comfortable and the chances of hyperpigmentation are less.  The Pico-second pulse shatters the ink into even smaller particles, allowing the body to more easily absorb the ink.  This type of device can usually remove unwanted ink in about half as many treatments as the traditional Q-switch devices.  It takes time for the body to absorb the ink particles, so it is a very lengthy process.  In our office we treat once every 8 weeks, or longer between treatments.  Plan on over a year of treatments.  You can click on the weblink below and put in your zip code to "find a provider" of this technology in your area.Good Luck!

Richard Rosol, MD · Answer

My experience has taught me that just about any tattoo can be completely removed with enough money and patience, barring visible scarring. Some of my most impressive results came from chest tattoos, in fact. 
I would encourage you to proceed with the help of a medically trained practitioner who provides appropriate anesthesia (that bad boy is gonna hurt, otherwise), preferably with picosecond laser capability. Also know that treatment # estimates go out the window when your goal is perfect baby skin. You could save yourself some expensive treatments by widely spacing them out to, say, 8 or 10 months, to allow maximal ink clearance. There is no clear evidence guiding treatment interval decisions, but I have had many patients take this “lightning slow” approach, with excellent results and cost savings.
In my book, anyone with an unscarred tattoo that isn’t completely gone just quit too early.
Good luck!

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