Tattoo Excision

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.