Tattoo Removal by Excision

I'm looking to get a tattoo removed. Its decently large. Its goes up about 10 inches wrist to a little over my elbow. The width is not very big. At some points its about 2 1/2 in width and others about 1 1/2. I'm not looking to try laser because i could put a lot of money into the tattoo removal and it wouldn't be a guaranteed removal. Any advice? Also can anyone give me a price range. Thanks!!

Doctor Answers 4

Excising a tattoo

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In order to excise the tattoo you need enough skin laxity to close the wound.  Generally the forearm doesn't have enough extra skin to close a tatoo excision like yours in one setting.  You might need a staged excision and you will have a big long scar from doing it.

Tattoo removal laser vs excision

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Excision is sometimes a reasonable option compared to laser. Excision always replaces the tattoo with a surgical scar, however. In some cases this may be acceptable if it avoids the multiple treatments needed with a laser. In larger tattoos it may not be possible to remove it all in one sitting without needing a skin graft which can definitely be unsightly. Serial excision, in which portions of the tattoo are removed with several weeks between excisions sometimes allows complete removal whole avoiding a skin graft. How feasible this is depends on the skin laxity in the area which differs by anatomic location and patient to patient.

Daniel Berg, MD
Seattle Dermatologic Surgeon

Tattoo Removal by Excision

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Thank you for your question and picture.  Depending on the size and position of your tattoo, it is possible to remove the tattoo in a single operation. If there is enough flexibility in the skin surrounding a tattoo, it may be possible to cut around the tattoo and draw the cut skin edges together with stitches. Typically an oval shaped cut is designed as this allows a neat, straight or slightly curved surgical scar to be made.  Your tattoo is extremely large therefore the skin not having enough elasticity. Staged Tattoo Removal may need to be an option, where removal of the whole tattoo would leave a gap in the skin which could not be drawn together easily with stitches, staged surgery can be used. 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 Skin Grafting an alternative to staged surgery 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 taken from. More importantly, grafted skin will in many cases be different in texture and appearance to the adjacent skin.These can be performed under local anaesthetic.  Please make sure you find a reputable and qualified plastic surgeon who can access you properly to give you a realistic idea of the outcome you can achieve. All The Best! 

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Laser tattoo removal

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you may not be interested in laser tattoo removal but nothing works as well. Unfortunately laser tattoo removal does require multiple monthly treatments and the expense, which usually is a few hundred dollars (more or less) per visit, adds up. One time procedures that are invasive will cause more scarring possibly.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.