Surgical Tattoo Removal: Surgery Methods, Costs and Risks

Great advances have been made in surgical tattoo removal. Surgery methods, costs, risks, and benefits are now well understood, so patients can have a clear idea of how to proceed when they seek to get rid of their ink.

Lasers are the most commonly used tattoo removal method. They break up the coloring agents into fragments that are then absorbed by the body, causing the tattoo to fade away. The method is somewhat uncomfortable, but patients are usually offered a topical anesthetic.

Laser removal is most successful with tattoos done in black or dark blue. Each pigment has a particular absorption spectrum, and light-colored or florescent tattoos have pigments that may fall outside or on the edge of the range of most lasers.

Large or difficult tats may also be treated by excision, that is, by actual removal of an area of skin, possibly followed by a skin graft. This method leaves a scar, but one that is less conspicuous than the tattoo, and this may sometimes be surgically modified later.

Laser tattoo removal

The Q-switched laser is the type most commonly used to remove tattoos. It is a handheld device slightly larger than a TV remote that gives off energy that passes through the outer layer of the skin without harming it. The laser energy focuses on the pigment of the tattoo, while the patient sits or lies down, wearing protective glasses.

The sensation may be uncomfortable, to the point that an anesthetic cream is sometimes used. Some people describe it as feeling like being repeatedly snapped with a large rubber band. Removing a small spot will take only a few minutes, but treatment of a sizable tattoo may take multiple sessions of 30 minutes or more.

Those who want an anesthetic cream should plan to arrive a half hour early, so the cream has time to take effect. After the treatment, the skin may look reddened, while the tattooed area may look white. Any soreness will quickly dissipate.

Skin naturally absorbs and removes small foreign bodies, but tattoo pigment remains trapped in the skin because its particles are too large to be removed. Laser treatments cause the pigment particles to fragment, and the body then gradually clears them away.

However, it may take repeated treatments, spaced out between four to eight weeks apart, to get rid of all the pigment. Someone with an extensive tattoo can expect removal to take eight treatments or more, possibly using different lasers tuned to remove various shades of pigment.

Surgical excision

Another way to remove a tattoo is to remove the skin that displays it. Small tattoos are excised, and the skin is then sewn together. Larger tattoos may require skin grafts, transplanted sections of skin from other parts of the body, to replace removed skin.

This procedure is no longer as popular as it was, because the newest lasers work so well. However, it can be effective on especially difficult tattoos, such as amateur tattoos with uneven ink patterns, and on pigments that resist the laser.

Tattoo removal costs

Costs vary, depending upon the number of treatments needed and the type of laser used. Some dermatologists figure costs by the square inch of the tattoo, and quite a few offer substantial discounts for prepayment of the entire treatment plan.

It may be possible to have a small dark tattoo removed for 500 dollars or less, while removing extensive sleeves or suits of heavy tattooing can cost thousands of dollars and take many months.

Some social service organizations offer tattoo removal at low or no cost for people who are trying to change their lives. Former gang members, former prisoners, and others who are referred to social service programs may qualify for these services in large cities. Some medical schools also offer low cost or free programs in which well-supervised medical students do the removal.

Risks of tattoo removal

Scars may be left behind when a tattoo is removed. The risk of scarring is minimized in patients who follow the doctor's instructions precisely. Patients should also avoid the sun as much as possible, both before and after treatment.

Some scars, such as the thick raised scars called keloids, can sometimes be improved with steroid treatments or further surgery. Other scars may be improved with surgical revision to minimize their appearance, after tattoo removal healing is complete.

Another risk in tattoo revision is infection. This is more likely to occur with excision and skin grafts than with laser treatment. It can usually be prevented with good aftercare and is treated with antibiotics if necessary.


Without tattoos, people have more freedom in choosing clothing, because they have nothing to hide. Strangers no longer judge them. Though it can be a grueling process for those with extensive tattoos, tattoo removal can give the people who stick it out a fresh start.

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