This tattoo is not a candidate for excision. There is not enough loose skin around it to allow for excision. If the skin is closed to tightly in this area, there can be impingement of nerves or tendons. Laser tattoo removal is the best for this. I prefer the Piqo4 or the Pico Plus. They have nano and picosecond pulse durations and multiple wavelengths to remove most colors.
Thank you for your question and posting a picture. I don't think you will find a surgeon that will recommend excision. There isn't enough surrounding tissue to close over the tattoo.Tattoo regret is very common. Almost every tattoo can be completely removed with enough time and treatments. The most important factor is patience. You have to give your body time to absorb the ink. For laser tattoo removal you have two routes.The older nanosecond or Q-Switch lasers that came out about 20 years ago. The majority of former Q-Switch patients we see have significant hypopigmentation (ghosting) around and under their tattoo. The Q-Switch lasers have trouble differentiating between the melanin in your skin and ink. The technology uses heat to burn the pigment out of your skin. In addition, we have seen patients with raised scars as if they have been branded. Both of these condition are typically irreversible. Picosecond laser came out about 4 years ago. Every laser manufacturer has a different marketing hook to make you choose their laser. At the end of the day, it's about the technology and experience of the clinician. All PicoSecond lasers (like the Enlighten, PicoWay & PicoSure) fire 1000 times faster per second, using a pressure wave rather than heat to shear the ink molecules apart. The hype of extra wavelengths does not make that much of a difference. The 755 nm will get rid of most of the ink colors. For red and pink ink, you would need to make sure they have 532 nm. After using the PicoSure for 3 and half years, we have only seen pinpoint hypopigmentation in a very small number of patients usually of darker skin tones. We cannot say it is impossible to get burned with a Picosecond laser, but it is highly unlikely. We tell every PicoSure tattoo patient to expect at least 6 treatments, but don’t be surprised if it takes 10 to 12. Patience is the key for our patients. We typically see our tattoo removal patients every 8 to 12 weeks initially. We eventually encourage them to wait up to 6 months as the tattoos seem to continue to fade while they wait.Treatment prices vary by market. The cost for picosecond treatments will be higher, but you should need less than half the treatments compared to a nanosecond laser. The patch is only used with the older nanosecond lasers. Best of luck
