Tattoo removal chances/options? Recently got this tattoo on my forearm and had regrets immediately after.

Question

im curious about what the best laser to go with would be to get it removed? also how high are the chances of scarring and whatnot. theres 2 shops near me— one uses a Picosure laser, and another uses an Astanza Duality laser. my tattoo has black, red, orange, and green on it, so i’m not sure which one would be the best choice. im not really interested in a coverup, i want it totally gone.

Monika Soni, MD · Answer

I recommend 6 weeks between PicoSure treatments.  I absolutely support a MILD chemical peel after the PicoSure laser, it really adds to the effects of the PicoSure.  I recommend the peel within 1-2 weeks of the laser which means you need at least 4 weeks from time of peel to the next laser treatment.  Look at my before/after pic for my PicoSure patient in my profile.  She had 6 chemical peels along with the 3 PicoSure lasers.

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.  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 PicoSure laser treatments will superior to the Astanza laser.  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

Tattoo removal chances/options? Recently got this tattoo on my forearm and had regrets immediately after.

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