Now You See it, Now You Don’t

Cosmetic Surgeon Francis Winski, MD, Attending, Plastic and Reconstructive Surgery at Westchester Medical Center, explains what’s involved in the art of tattoo removals.

Does a tattoo have a lifespan?
Yes. If you look at older gentlemen who have tattoos from the 1920s, the tattoos are fuzzy, and it can be hard to identify colors and shapes. That’s because the body breaks down the pigments and removes them. With lasers, we speed up the process. Lasers break down the pigment molecules so the body can remove them. Tattoo removal time and treatment depends on the dyes and how they’re applied.

Are there standards of inks and processes that tattoo artists use to give tattoos?
There are no standards, and that’s what makes it very interesting. Sometimes we have tattoos over a tattoo. That makes it more difficult. You’re dealing with twice as much pigment in different layers, or even in same level in the tissues. Sometimes, with unknown dyes, if we use a laser, it will turn the tattoo black, and that doesn’t fade. We can do a test spot to see if the patient has that reaction or not.

What factors do you consider in treatment?
Different frequencies of laser are required with different colors of tattoos. The darker colors are usually more responsive to lasers than lighter colors. Blue and green tend to be the hardest to remove. For those with fair skin, it is easier to get rid of tattoos than those with olive or dark skin tones.

How long do the treatments take?
That depends on the quality of the tattoo. Sometimes we see fading after two or three treatments, or sometimes we need eight to 10 to get everything. The treatments are generally spaced several weeks apart.

What advice do you have for those considering a tattoo?
Make sure it’s what you really want. For certain career options, it’s not appropriate. For instance, if you’re looking for a job in law enforcement, and the tattoo is exposed with a short sleeve shirt, you have to get rid of it or they won’t take you. Use some degree of common sense.

What things should one ask a tattoo artist?
Ask what happens if you get an infection. Do they have a working relationship with a doctor if they get a problem? Infections happen every now and then. What type of sterilization is used? Are the needles used more than once? You can re-sterilize needles, but you generally wouldn’t want that. Some sterilization processes don’t get rid of all the bad stuff. You could be more at risk for something like HIV or hepatitis from infected equipment.

Any other advice?
Sometimes people get a tattoo, and it hasn’t even healed, and they want to get rid of it. Instead of getting the permanent tattoo, consider a temporary tattoo. It’s more expensive to get rid of a tattoo than to get it. There’s always a potential for scarring. This isn’t perfect, although the technology is getting better all the time. Use common sense when you get your tattoo. Make sure it’s what you want. •