What to do about a tattoo

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Tattoos are always going to be controversial.  There will always be those who love them and those who hate them; those who cover themselves in them and those who abhor them and those who have one or two to commemorate special people or times in their lives; those who think they are awful and those who don’t hate them but don’t want them.  All of this is absolutely ok with us!  It’s your body and you should use it as you see fit.  The only reason we want to impart a little advice is because so often we see people who are unhappy with their tattoos struggling to get rid of them…and we feel we may have an unconventional solution!

We see a lot of patients searching for a last resort solution to unwanted tattoos after they’ve exhausted all other options including laser, which essentially means cutting them out.  This leaves the patient with a scar, which is usually quite large, but no more tattoo and surprisingly this seems to be acceptable to some people.

Getting a tattoo is obviously a very personal choice and removing one is no less personal.  In our experience once someone has decided a tattoo is no longer serving them they will do ANYTHING to get rid of it.  In worse cases this involves applying acids and heated spoons to the tattoo in an attempt to burn it off, leaving unsightly scars and a muddle of pigment behind.  In better cases patients will undergo multiple laser treatments with varying levels of success in order to blast the tattoo away.

The reason laser is inconsistent is really the fault of the tattoo artist, not the laser.  Biopsies of different tattoos show that the depth of the tattoo pigment is dependent on the skill and equipment of the tattoo artist, with better-looking tattoos being more superficial with only a thin layer of skin covering the tattoo making the image sharper and displaying finer detail.  Coarser tattoos that appear slightly blurry or clumsy have pigment placed at greater depth with a thicker layer of skin covering the pigment, making the tattoo less attractive and more difficult to remove using laser and other means.

Laser tattoo removal is still one of the best options for removing black tattoos.  Essentially what the laser does is shatter the pigment particles, making them small enough for the patient’s white blood cells to gobble them up and dispose of them, leaving untattooed but occasionally scarred skin behind.  When it comes to coloured tattoos though, many of these pigments will simply reflect the laser energy rather than absorb it, rendering the laser ineffective.  The only way to get colours to absorb the laser would be to use a laser with multiple beams that each have a different colour so that each colour tattoo can be targeted with a specific laser beam that is the opposite colour of the tattoo which would then shatter the pigment particles and remove the tattoo.  This becomes a problem particularly with trying to remove red pigments, since blood will also be targeted by such a laser causing further damage to blood vessels which can in turn affect the quality of the treated skin.

So the last resort becomes surgical excision by a plastic surgeon, who will ensure the “best” scar possible in these cases.  Part of the skills a Plastic and Reconstructive Surgeon has is understanding that the nature and quality of scarring varies greatly in different anatomical areas.  Excising a tattoo over the deltoid muscle (the upper outer part of your arm where a badge would usually be sewn onto your sleeve) will almost certainly lead to unsightly scarring, whereas excising a tattoo from the area where you would commonly have an appendicectomy scar could leave an almost invisible scar, simply due to the differing amount and type of movement in the area, sun exposure, and due to the differing kinds of skin found in these areas.

It was on mulling over this problem that we came up with a new approach to dealing with this problem.  We know that this approach may not be everybody’s cup of tea, and that if you went into getting a tattoo with the thought in mind that you may like to remove the tattoo then you possibly wouldn’t get it in the first place, but bear with us!

Plastic Surgeons are in the business of removing large pieces of skin (+/- underlying tissue) in order to achieve a cosmetic result: think tummy tuck, breast reduction, breast lift, face lift etc.  With that in mind we thought of how convenient it might be if the unwanted tattoo were placed in an area where removing skin could actually have a cosmetic result too, so that an operation labeled as “tattoo removal” would end up giving you a flatter tummy, or perkier boobs!

At the end of the day if you’re unsure of how long you’re going to love your tattoo for our advice is always “don’t do it!”, but if you absolutely must have that tattoo then perhaps consider confining your tattoos to areas that could do with a bit of a tuck in the future?  In fact we are happy to mark out these areas for you prior to getting your tattoo so that your artist knows which boundaries to stick to.  This way if you love your tattoo you can keep it for life, and if it loses its shine after a few years it can simply be cut out in one small op with little scarring and perhaps leaving you looking even better than you did before, rather than having the disfigurement of partially removed tattoos and unsightly scarring!

Think about it…

To book an appointment to find out more about excising tattoos, OR to map out areas where tattoos can be easily removed prior to getting ink give us a call on (021) 683 3048 extension 1.

For laser tattoo removal we recommend Laserderm.  You can book an appointment with them on (021) 683 5060

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