Is it possible to do multiple excisions on a large new tattoo?

Tattoo excision is a common treatment - especially after failed laser treatment. In most cases, you will have to have serial excision. What this means is that as much of the tattoo is excised that will allow minimal tension on the closure. After the area heals, another excision is performed using the same incision/scar, but removing another ring of tissue. This process is repeated until the entire tattoo is completely removed. Good luck.

Thank you for your question Joseph.  Unfortunately due to the size this would have to be performed via staged tattoo removal, a comfortable amount of the tattoo is removed to allow stitching of the wound.  A few months later, the surgical wound will be well healed and the skin will have stretched enough to allow a further portion of the tattoo to be removed.  A further variant to this could be the use of a tissue expander, a surgical ballon designed to stretch an area of skin in preparation to fill a gap left by the removal of a tattoo.  Alternatively using a skin graft, where skin, taken from another area of your body, can be used to fill a gap which cannot be drawn together with stitches.  This is a single operation however it leaves a second mark or scar on the body where the skin graft is take from.All the best! 

Laser tattoo removal may be an excellent modality alone or in combination with surgical excision to minimize the downsides of either treatment. Best. Dr. Karamanoukian 

Tattoo laser technology has made significant advances in recent years that less treatment sessions may be required compared to what we had in the past. Q-swtiched Nd:Yag laser is the gold standard. Ink particles deposited underneath the skin get vaporized by Q-switched laser and taken up by scavenger cells of our immune system. Excisional removal should be the last resort as the cosmetic outcome is by far superior with tattoo laser removal.

Hi there-

With technological advancements in lasers, there is no question that particularly with a large tattoo, your best option for removal would be through a laser treatments.

Specific lasers are required, as not just any would work, but this would be your best bet.

We agree with the panel that lasers should be the first option. We have seen several tattoo removal procedures done with grafting and the patients have not agreed with you that they would be ok living with the scars. They are horrified when they see the scars.
Why are laser treatments not an option as we treat areas as large as a full back at our practice?

There are many larger tattoos that have been effectively removed or significantly faded by laser treatment. Serial excisions can be done but there is a risk of a painful raised hypertrophic scar. Try the laser first.

This is too large to excise. Although it is possible the cost will be prohibitive and it will leave a terrible scar which can keloid .Laser is a viable option for larger tattoos even if done in sections a few weeks apart. I have done large tattoos. It is impossible to guarantee complete removal al igniter tattoo with scattered residual ink is preferable to painful ugly scar.

Excision of tattoos is no longer necessary when you have the technology available from the Alex Tri-Vantage laser.  The laser is uniquely qualified to treat all colors of tattoos in all skin types.  This painless procedure is the best way to remove a large tattoo and makes excisions a thing of the past.  For the best cosmetic results please consult a board certified dermatologist with experience with tattoo removal.

You would be best served by seeking a knowledgeable surgeon who has experience with both laser tattoo removal as well as serial excision of tattoos so that you may fully understand the pros and cons of the two options.  I personally believe your best option would be to undergo laser tattoo removal of the forearm tattoo as a you will most likely obtain a very acceptable clearance of your tattoo ink with minimal chance of scarring as opposed to surgical excision.  A high quality tattoo removal laser used by a knowledgeable and experienced physician will give you an excellent result. Best Regards,Jacque P. LeBeau, MD