Tattoo Excision overview
If you have had a tattoo that you now would like to remove, you have several choices. If the tattoo is small, and there is some loose skin in the vicinity, you may be able to surgically remove the skin containing the tattoo. This will produce a scar, but if it is practical, is the simplest and most complete treatment available. If the skin is somewhat tighter, it might still be an option, either by removing the skin in several steps, by using a balloon to expand the nearby skin, or by moving a flap of skin from a location that has some extra.
Other options include covering the tattoo with makeup and/or another tattoo.
However, if those options are not practical or desired, laser tattoo removal may be your best option.
Tattoo Excision Reviews
"Tattoo Excision - The confidence and professionalism of all the staff was reassuring. Dr Nachbar’s attention to detail and understanding of my concerns along with his understanding of my desired outcome was important. They all made me feel so comfortable and relaxed. This is the kind of experience I want to have with my doctor."- Anonymous / RealPatientRatings / Apr 04, 2018
"I came in for a tattoo excision procedure over a year ago & I have no complaints about my experience! I never write reviews but since I had such a hard time finding information/reviews on this particular tattoo removal procedure when I was making my decision, I figured I should make sure to tell the world about my awesome experience with Dr. James Nachbar in case someone is in the same situation I was. The entire staff was fantastic & there's barely a scar leftover. He will definitely be my go to for any procedures I choose to do in the future. Thank you!"- L.G. / Google / Apr 11, 2018
"Excellent doctor very kind and very warm and pleasant as well - Excellent bedside manner ladies in the office are very nice. I went back over a period of a few years to surgically remove a tattoo. It was a difficult project but he was able to get it all. From start to finish him and his staff made sure I was comfortable in the operating room. I also find him to have a very good demeanor. Cosmetic surgery is of a personal nature and it’s very important to h..."- H. / RealSelf / Aug 15, 2018
"I cannot say enough great things about Dr. Nachbar and his staff. Since his staff were my first and last points of contact, I'll start with them. They were incredibly friendly and helpful. I flew in from out of state for tattoo excision. From the initial contact to walking out the door following my surgical follow-up the day after the procedure, they were kind, polite and accommodating. The smiles and kindness don't feel put on or forced -- his staff seem to be genuinely happy, nice people. Dr. Nachbar was very polite and extremely good at what he did. He gave me a great explanation of what he would do and he was able to exceed my expectations. I had minimal post-surgical pain -- I have actually managed my pain with OTC pain relievers, although he did give me a prescription. Dr. Nachbar was very respectful and treated his staff in a respectful fashion as well. I was very happy with the treatment I received and I highly recommend Dr. Nachbar. I legitimately wish I had known of him and seen him first for excision tattoo removal before spending $2K on laser treatments that had no measurable affect."- E.J. / Yelp / Sep 20, 2018
"Five stars isn't enough for Dr. Nachbar and his staff! I traveled from Dallas to Scottsdale for a tattoo excision, and my experience was excellent. Daisy was very sweet and helpful with my long-distance consultation (and even sweeter in person!). Dr. Nachbar is wonderful and made the entire process very comfortable. For others like myself that have not had results with laser tattoo removal, this is an effective and affordable alternative. I will definitely be returning to have another tattoo removed. I highly recommend Dr. Nachbar!"- J.T. / Yelp / Apr 26, 2019
laser removal vs. Excision
The reason you have a tattoo is because the particles of tattoo pigment are too large for your body to remove. The laser works by sending light through the skin. The skin does not absorb the light, but once the light hits a particle of tattoo pigment, the pigment absorbs the energy of the light. That energy causes a portion of the pigment particle to break off. If the fragment is small enough, the body can then remove it, lightening the tattoo.
Laser tattoo treatment typically produces some lightening of the tattoo with every treatment. After enough treatments, the tattoo may be light enough that it is much less obvious, even so that it no longer looks like a tattoo. How many treatments are required is hard to say in advance, but is affected by the kind of pigment used, the color of the pigment (and thus how well it will absorb the laser light), the density of the pigment, and how completely the tattoo must be reduced for you to be satisfied with the result. I generally tell patients to expect to do between six and twelve treatments, but in any given case, it may be less than six or more than twelve. Treatments are about six weeks apart, to allow healing of the treated area.
Laser tattoo treatment can usually be done with little to no scarring, although scars do sometimes occur. Also, the tattoo will lighten with each treatment, but if you look closely, it will sometimes be visible.
Laser tattoo treatment generally requires multiple sessions, and may take a long time to maximum improvement. Different lasers will remove different colors of tattoo ink at different rates, so matching the tattoo ink to the laser is often helpful. However, because there is no standardization of tattoo inks (i.e., different tattoo artists may use different materials to create a "red" tattoo), it can often be difficult to know in advance how well each color of ink will respond to the laser treatment, and a trial treatment may be appropriate.
Although laser tattoo removal often works and produces less or no scar, sometimes a smaller tattoo is better treated by excision (cutting out the tattoo). The most common situation is when a recruit for the military or police force has one or a few small tattoos in more visible areas, such as the hands, forearms, face or neck, and they must be removed before they can start training. In other cases, patients may have tried laser tattoo removal, but the ink just isn't responding to the laser. Also, some inks do not respond to treatment with the laser, especially light or flesh-colored tattoos will sometimes just darken if the laser is used.
One patient had what appeared to be an allergic reaction to a tattoo on the wrist. She not only had a reaction when the tattoo was placed, but a low grade reaction continued after the tattoo was placed, and worsened each time she had a laser tattoo treatment.
Whatever the reason, if there is a tattoo that must be removed quickly, excision may be an option. However, excision is a much better option when the tattoo to be removed is relatively small, with some loose skin around the tattoo that can be used to close the excision. The amount of skin available varies in different parts of the body. For example, there is a lot more skin on the neck than on the finger.
Larger tattoos might still be treated by excision, but if there is not enough skin nearby, multiple procedures, separated by three or four months to allow skin relaxation, may be needed. Sometimes, larger tattoos can be excised with closure using flaps from nearby or from more distant parts of the body. Even larger tattoos cannot be excised that way, but may require a skin graft to cover the area. The scars from a skin graft are quite significant, and occur both where the skin graft is place, as well as the part of the body where the skin is taken. Because of that, it is rarely practical to excise a tattoo that is so large that it will require a skin graft.
When a tattoo is small enough to excise and close, the procedure can usually be done in the office, for a cost generally between $1,200 and $1,800 per procedure. When multiple excisions are required, there is generally a cost for each one, but that will be discussed at your consultation before your first excision procedure. Sometimes if there are several small tattoos to excise, they can all be excised at the same time.
When excision in the office is appropriate, it is done under local anesthesia and you go home right afterwards. However, we recommend that you have someone drive you home after your excision.
The only way for us to be able to tell whether we will be able to excise your tattoo is for us to see it. Often, patients for whom a visit to Scottsdale is less convenient will email a photograph of the tattoo, and we may be able to give you some information over the phone.
If you are thinking of tattoo excision, call us for an appointment for a complimentary consultation, or for information on sending us a picture of your tattoo so we can discuss it. We look forward to meeting you!