Is tattoo excision possible? (Photos)

Question

I got both of these tattoos on my forearm and loved them at first but now I feel super insecure about them and want to cover them constantly. The "loved" one is in my grandmas handwriting which is nice but the rose has no meaning and it seems way too big. Ive done some research about tattoo removal and it seems excision is the better option. Is it possible on a tattoo this size? And would I be stuck with an ugly sized scar? Please help!

J. Jason Wendel, MD, FACS · Answer

Thank you for your question in regards to tattoo removal. Because of the location of your tattoos, excision would not be your best option. That would leave you with more scarring than necessary. Laser tattoo removal would be your best option to remove your unwanted tattoos. To be sure what is best for you, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

Jason Emer, MD · Answer

I don't recommend excision. Laser tattoo removal is the gold standard for removal. Tattoos should be removed with q switched or pico lasers. It will take a series of treatments. I recommend getting a formal evaluation with a laser tattoo removal expert. Best, Dr. Emer

Laura Riehm, MD · Answer

Thanks for your question and posting pictures.  Tattoo regret is very common.  Almost every tattoo can be completely removed with enough time and treatments.  There should be no need for excision.  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.Nanosecond or Q-Switch lasers 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 irreversible.  Picosecond laser came out about 3 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 almost 3 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.  If they have more time than money, we encourage them to come every 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.

Mark A. Blair, MD · Answer

Hello, thank you for your question and for including photos.  I definitely do not recommend excision.  Both of these tattoos are light in ink and should be able to remove fairly easy.  Black ink is the easiest color to remove.  The way a laser rids the skin of unwanted ink is, it shatters the ink into tiny particles and your body absorbs those particles. 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.  I might guess that this type of tattoo can be removed in as few as 3-5 treatments with this technology.  You must be patient, it takes time for your body to absorb those ink particles, so waiting time between appointments is of most value. We retreat about once every 8 weeks.  You can click on the weblink below and put in your zip code to "find a provider" in your area.Good Luck!

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