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Laser Tattoo Removal

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{ Laser Tattoo Removal }

What is laser tattoo removal?

Tattoos are created by a pigment being inserted into the undercarpet of the skin called the dermis.  The pigments used to create tattoos come in a variety of colours and formulations.  The modern versions of tattoos often come in multiple colours in addition to black, dark green.  It is very common for Toronto laser tattoo removal patients to present with yellow, red, bright blue, orange and purple.  With tattoos being so common in the modern era, it is inevitable that laser tattoo removal would have increased proportionately.

It is estimated in North America that over 50% of all women between the ages of 18 and 45 have a tattoo and 45% of all men in the same age group. Unfortunately, tattoos are generally for life and the emotions and motivation that resulted in the tattoo may not.  Thus, eventually there is between a 25% and 35% regret factor with the tattoo that was created.

At SpaMedica, laser tattoo removal has been an innovative and important part of laser cosmetic dermatology and laser med spa since Dr. Mulholland, a Toronto Cosmetic Plastic Surgeon, created the center 1995.  SpaMedica is Canada’s most experienced multiple-wavelength laser tattoo centre in Canada. Dr. Mulholland’s approach has been to acquire the most efficacious lasers in the medical space to optimize the efficacy and degree of permanent reduction and to minimize the side effects on the skin.  Most Tattoo removal centers offer one laser and 1-2 wavelengths of light and it is common for patients to plateau with their laser removal and even after 12-16 treatments at these clinics with a limited number of lasers patients tattoos become recalcitrant or resistant and new lasers and wavelengths need to be deployed. At SpaMedica, Dr. Mulholland has assembled six of the most efficacious lasers ever made, as well as every wavelength of laser light used to remove tattoos, to ensure you achieve the optimal laser tattoo removal outcome in the fewest number of treatments and most affordably. Dr. Mulholland’s approach is to treat the tattoo with a number of the most effective lasers to achieve on average 90% ++  tattoo removal in as few as 4 laser treatments.

How is laser tattoo removal performed?

After a thorough history and physical examination with one of SpaMedica’s laser physician specialists, a multiple-visit treatment program is outlined.  With SpaMedica’s latest generation of laser tattoo devices, such as the Picosure™ and the Revlite™, the average number of treatments for the average tattoo is 4 treatments for over 90% clearance. Depending on the size and number of colours in the tattoo will often determine the ultimate number of laser treatments required.  A laser is then selected to initiate the treatment and the appropriate settings for the laser are selected and the tattoo undergoes a laser treatment.

Laser tattoo removal

Figure 1.  A. Microscopic image of the ink particles inside a tattoo. These particles must be broken up by a tattoo laser.  B. Standard, weaker, less effective tattoo lasers break up the ink particles using heat and the ink particles are broken up into “pebbles” which are larger and harder to remove by the body, hence more treatments and eventually residual pigment remaining. C. The modern SpaMedica lasers using gated nanosecond pulses and multiple wavelengths, like the Revlite™ or actual picosecond pulses (1 trillionth of a second) like the PicoSure™ to break the tattoo ink particle in “fine grains of sand”, which are tiny than the “pebbles” of longer pulse duration lasers and easier to remove quickly by the bodies natural systems, resulting near total clearance in fewer treatments.

How does a Laser Damage the Tattoo Ink?

The specific energy from the light beam is directed at the skin where the laser pigment resides.  Depending on the type of laser, the light energy interacts specifically with the tattoo particle to injure and remove it. The injury to the tattoo in particles can be thermal (longer pulsed lasers) or more photoacoustic (non-thermal), like the new Ultrashort pulse duration lasers.  Unlike some lasers that rely on heat, the more  high tech and modern tattoo lasers, such as the Picosure™ and Revlite™ have a much, much shorter pulse duration and they rely less on a heat injury and more of a mechanical acoustic shattering of the pigment. With photomechanical acoustic injury, generally the ultra, ultra-short wavelengths create a shockwave in the skin, in around the ink particles, and shatter the particles.  The shattered particles or the tattoo then flake off from the surface of the skin and the deeper ones are consumed naturally by the body’s elimination and immune system. These ultrashort pulse duration photoacoustic lasers, are much more efficient, are able to shatter the ink particles into very tiny sand like grains of sand which are easy for the body to digest and hence the tattoo is removed much more quickly. In addition to removing the tattoo in as little as 4 treatments, the PicoSure™ and Revlite™ lasers, with their photoacoustic rather than predominant photothermal effect have a much lower risk of “ghosting” of the surrounding skin, which is a white color where the tattoo used to be that is lighter than the surrounding skin due to the thermal damage to the actual pigment cells in the skin, the melanocytes, that occurs during the treatment.

In general, older tattoo removal lasers require takes multiple sessions; often in the order of eight to 12 sessions, which, even at affordable prices per session, can end up being expensive. However, Dr. Mulholland has assembled a multiple laser approach, using the Revlite™, Picosure™, Accolade™, Affinity™ and even  fractional CO2 at the very end, the number of laser sessions can be reduced to 4-6 with over 90%+ clearance on average. Each session may take between 15 and 30 minutes, depending on the size of the laser.  Most of the procedures are performed under topical anaesthesia and an air chilling device, although some patients may prefer local anaesthesia.

What specific Tattoo Removal Lasers and Wavelength lengths does SpaMedica have and what tattoo colors do these work?

At SpaMedica, Dr Muholland has assembled the finest laser tattoo removal devices that are available in medicine.

The following is a list of SpaMedica Laser Tattoo devices, pulse duration of those lasers and the tattoo color they work on:

1.  The PicoSure™ 755nm Picosecond pulse duration and works on all colors including Black, Green, Blue, Yellow, Purple, Orange, Red, Yellow and white tattoo ink

2.   The Revlite™ 1064nm, 650nm, 585nm and 532nm  gated, Nanosecond pulse duration and works on Black, Green, Purple, Blue, Red, Yellow and Orange tattoo ink

3.   The Affinity™ 1064nm and 532nm gated, Nanosecond pulse duration and works on Black, Green, Red, Orange and Yellow tattoo ink

4.   The Accolade™ 755nm gated Nanosecond pulse duration and works on Black and Green tattoo ink.

5.   Fractional CO2: A fractional ablation laser that is useful on multiply treated tattoos where some stubborn, residual ink is present, but faded and cant be lifted off, this fractional ablation laser used by Dr. Mulholland for wrinkle and acne scar reduction can also be used successful of partially faded tattoo removal

6.   Fractional Radiofrequency (RF) ablation: Like Fractional CO2, the Fractional RF ablative device can be used to fade already treated tattoos which have become lightened.  The advantage of the Fractional RF system, also called the Fractora, is that the top part of the needles can be silicone coated to the epidermal skin over the tattoo may not get damaged, but the tattoo ink particles can be selectively targeted. .

The newest and most popular of the laser tattoo removal devices is called the PicoSure® laser.  The PicoSure® laser tattoo removal laser is made by Cynosure.  What makes the PicoSure® so special is its extremely, extremely ultra-short pulse duration.  Most current Q-switched or ultra-short pulse duration lasers are measured in nanoseconds, which is a Billionth of a second.  The picosecond is a Trillionth of a second and its extremely short pulse duration means that the PicoSure® can remove any colour of tattoo pigment on any skin type in half the number of treatments that would normally be required.  In addition, because it is the most pure acoustic, photomechanical laser tattoo device ever created, it is less likely to have a thermal effect and more likely to have a mechanical effect.  The thermal side effects of laser tattoo removal include loss of pigmentation in the skin where the tattoo resided and/or textural changes or scarring.  The absence of any significant thermal effect and the pure reliance on photomechanical or acoustic shattering of the pigment makes the PicoSure® the safest, most effective and most efficient tattoo removal device on the market.

The Picosure™ laser

Figure 2. The Picosure™ laser.  The Picosure pulse duration is a Trillionth of a second, is virtually all photomechanical, with no photothermal effects and is the KING of all tattoo lasers.

Other lasers that are also used at SpaMedica for laser tattoo removal include the RevLite®.  The RevLite®, made by ConBio™ (and recently purchased by Cynosure) It is the world’s best gated, pulse sequenced nanosecond pulsed laser tattoo removal device.  What makes the RevLite® special is the multiple wavelengths of light that come with the system.  The RevLite® includes the nanosecond, gated pulse sequenced 1064 wavelength for dark black and dark green inks; the 532 nanometer, nanosecond pulsed wavelength for reds, yellows and oranges; the 585 nanometer, nanosecond, gated wavelength for purples, blues and the 650 nanometer, gated, nanosecond wavelength for light greens.  The Revlite®, up until early 2014, had always been the first and foremost lead laser technology used on tattoos.  Now, with the picosecond pulse duration, the Picosure has become the dominant world player in this market. However, Toronto laser tattoo removal patients may still benefit, on occasion, from a use of the RevLite® when the PicoSure®, in those rare instances, fails to remove the targeted pigment, most commonly the red tattoo ink dyes.  It is common for SpaMedica Toronto Laser Tattoo removal patients will receive treatments on 2-3 of SpaMedica’s tattoo removal lasers, such as the nanosecond, high-tech lasers available at SpaMedica for laser tattoo removal include the Accolade™ by Cynosure; a nanosecond Q-switched Alexandrite 755 nanometer laser and the Affinity™, also manufactured by Cynosure, with a nanosecond, gated pulse, 1064 nanometer, 532 nanometer wavelength.  The use of multiple lasers and wavelengths by the SpaMedica Laser tattoo removal team, means fewer treatments, less ghosting and better clearance.

With this array of lasers, Toronto laser tattoo removal patients can rest assured that at SpaMedica, they will get the best possible permanent reduction with the least possible side effects.

The Revlite™ Laser Tattoo device

 

Who is a candidate for laser tattoo removal?

Candidates for laser tattoo removal procedure are those patients with a tattoo that they are unhappy with its appearance and would like to have all or part of that tattoo removed in the least possible number of treatments, affordably and  with the least possible side effects.  Candidates for laser tattoo removal are tattoo patients of any skin colour.  Even darker skin type patients can be treated with the PicoSure® laser tattoo removal device although very dark skin types have more side effects due to the large amount of brown pigment in their normal skin. Good candidate should have realistic expectations in that they should anticipate 80% to 100% reduction of their tattoo after 4-8 treatments.  The treatments can be performed under local anaesthesia and a topical chilling device.

What are the Contraindications for laser tattoo removal?

The contraindications to laser tattoo removal treatment, can included those Toronto tattoo removal patients with unrealistic expectations and/or those individuals with severe wound-healing diseases or metabolic conditions, such as uncontrolled diabetes or lupus and scleroderma, or tattoo ink that oxidizes and changes color with treatment.

What kind of anaesthetic is used for laser tattoo removal?

Most Toronto laser tattoo removal patients have their tattoo removed at SpaMedica under topical anesthetic (anesthetic cream) with an air chilling system, where the cold air applied to skin provides additional anesthesia. In most instanced, SpaMedica Laser tattoo removal patients describe the tattoo removal as far less painful than the tattoo itself. In some circumstances, some patients prefer the use of local anesthesia that is injected under the skin, rendering the laser tattoo procedure painless.  Of course, there is a modest amount of pain associated with injection of the local anesthesia. Most SpaMedica laser tattoo removal treatments are very short and last a matter of five minutes and are well-tolerated under topical local anesthetic cream and air cooling.

Is laser tattoo removal laser painful?

Laser tattoo removal is generally well-tolerated by patients.  Under topical anaesthesia and and air cooling device and/or local anaesthesia, the procedure is generally described as comfortable and less painful than getting the tattoo in the first place.

How long does laser tattoo removal and PicoSure® laser treatment take?

The actual laser tattoo removal treatment lasts between five and ten minutes.  The procedure is quick and efficient and results in a small, white frosting on the surface where the tattoo pigment is.  This white frosting fades to a mild red, swollen appearance on the tattoo, which turns into a crust over 24 to 48 hours.  In general, for the first four to five days, topical anaesthetic ointment is placed on the tattoo and an occlusive dressing to prevent rubbing.  The tattoo itself can be washed immediately the following day after treatment and then the simple dressing is re-applied.  Once the crusting has fallen off, the tattoo continues to fade and, in general, 15% to 25% of the tattoo occurs after each laser tattoo removal treatment.

How long is the recovery following laser tattoo removal ?

Immediately following the laser tattoo removal treatment there is a frosting that lasts 15 minutes and then becomes a crust. The recovery period is characterized by flaking and redness for approximately seven days.  Topical antibiotic ointment and occlusive dressing, with frequent tepid water cleansing in the shower is all that is required post-treatment.  It is recommended that sun tanning or sun avoidance is followed for several weeks following each treatment to avoid hyperpigmentation of the treatment area.  After two weeks, most tattoos can also then have cosmetic makeup or cosmetic foundation and cover-up placed over it.

Laser Tattoo Removal

Figure 4. A series of Laser Removal Tattoo treatments showing the results. Immediately after the Laser tattoo treatment, Toronto Tattoo removal patients will experience a white frosting that will fade over the first 15 minutes and form a crust. The crust comes off over 5-7 days and some of the tattoo ink will come off with the crust and some will fade internally over the next 6-8 weeks.  Each laser tattoo removal treatment is therefore performed every 6-8 weeks. The third photo shows the 6th treatment and then the 8th treatment in the final photo. There is some ghosting of the skin.  But near 100% tattoo removal.

What kind of results can Toronto laser tattoo removal patients expect following their laser tattoo removal treatments?

In general, with SpaMedica’s unique combinations of lasers and wavelengths, including the Picosure™, Revlite™, Accolade™ and Affinity™ lasers , Toronto laser tattoo removal patients can remove, on average, 85% to 100% of a tattoo after four to eight treatments.  Each treatment is approximately six to eight weeks apart.  This is a far more successful laser than any other laser system, where between eight and 16 treatments are required for 65% to 80% reduction.  One of the big advantages of the PicoSure® laser, in addition to fewer number of treatments is that its pure acoustic or photomechanical effects and near absence of a photothermal effect results in less redness and inflammation and in far less risk of hypopigmentation or lightening of the skin where the tattoo existed; a phenomenon called “ghosting”, which is not uncommon with other laser devices.

What is the difference in recovery and outcome between the PicoSure™ and Revlite™ laser tattoo removal?

The PicoSure™ laser tattoo system is the “king” of tattoo removal devices. The Picosecond pulse duration (one trillionth of a second) is the shortest pulse duration in the industry. The short pulse duration of the PicoSure™ means more photoacoustic effect on the tattoo particles and they are shattered into the “finest grains of sand” for easier disposal by the body. Because the PicoSure™ has less thermal effect than other lasers there is less redness and swelling during the immediate recovery and ultimately, less thermal effect means less risk of the white ghosting of the skin that can occur after laser tattoo removal. The Picosecond pulse duration means, more efficient shattering of the tattoo particle by the PicoSure™ and more rapid clearance of the tattoo ink particles after each treatment, meaning, 90%+ total tattoo clearance after only 4-6 treatments with the PicoSure™.  On the other hand, The Revlite™ is the “King” of the nanosecond Q-switched Tattoo removal systems.  With a pulsed sequenced, inter-pulse delay there is less ghosting with the Revlite, even though its pulse duration is nanosecond (one billionth of a second, rather than one trillionth with the PicoSure) and with its 4 versatile different wavelengths of laser light, the 1064nm, 585nm, 650nm and 532nm virtually all tattoo ink colors can be treated, but clearance of 80% often requires 8-16 treatments. Dr. Mulholland and SpaMedica will use the Picosure on the first 4-6 treatments, but Toronto Laser Tattoo removal patients will benefit from the Revlite™ if there is red tattoo ink that is resistant to the PicoSure.

Laser tattoo removal

Figure 5.  A black and dark green ink tattoo on the back of a SpaMedica laser tattoo removal patient, 24 hours after treatment. The Left side of the tattoo had been treated with the PicoSure™ and the right side with the Revlite™.  On the right side (Revlite™) you will notice that there is a lot of redness and inflammation around the laser treatment. On the left side (PicoSure™), there is edema and swelling of the tattoo ink, but very little if any redness or inflammation, which highligths the advantages of the picosecond technology, which is more photoacoustic and less photo thermal, than the nanosecond technologies which are more thermal and hence are associated with more redness, swelling and inflammation and a higher probability of ghosting or lightening of the surrounding pigment.

Laser Tattoo Removal

Figure 6.  A.  Black ink tattoo, the top half was treated with a top line nanosecond Nd:YAG 1064nm laser while the bottom half was treated with the PicoSure™.  B.  The appearance of the tattoo 6 weeks after the 3rd treatment, notice the top half treated with the Nanosecond technology has faded 40-50%, while the bottom half of the tattoo, which was treated with the picosecond PicoSure™ has well over 90% reduction after only 3 treatments.

Laser Tattoo Removal

Figure 7.  Typically, blue, yellow and red tattoo ink particles have been difficult to remove with laser tattoo removal systems.  A.  Blue, yellow and black tattoo treated on the left side with a Nanosecond NdYAG   1064nm laser and on the right side a PicoSure™.  B.  One month after 5 treatments, the left side NdYAG nanosecond laser has removed approximately 50% of the tattoo, while the PicoSure™ has removed over 80%.

Laser Tattoo Removal

Figure 8A. A difficult to treat and remove, black, green, yellow and orange ink tattoo treated with the highly successful SpaMedica multiple wavelength and multiple laser approach.  B. 6 weeks after the 6th treatment with a near 100% tattoo removal result and no hypo-pigmentation.

What are Toronto laser tattoo removal patients saying about the SpaMedica laser tattoo removal program?

Most patients are ecstatic about the Toronto laser tattoo removal program and the PicoSure® laser.  Most patients achieve 90%+  tattoo removal in far fewer treatments than other centers and with fewer side effects.  Toronto Laser tattoo removal patients treated at SpaMedica can achieve on average near 100% remove, or near total cure, in a few a 4-6 treatments.

Laser Tattoo Removal

Figure 9.  A.  Multi colored SpaMedica laser Tattoo removal patient with Black, green, yellow and red ink.  B.  One month following the 6th treatment using the PicoSure™ and then the RevLite™ lasers with near 100% clearance.

What do I do about a resistant Tattoo?  What do I do if I have had multiple laser treatments at different tattoo clinics with different lasers, can SpaMedica make a difference?

There are many patients in the SpaMedica tattoo removal program who have had multiple treatments with other systems, at multiple clinics and have recalcitrant, resistant or difficult-to-remove pigment.  This difficult-to-remove pigment and these multiply-treated tattoos generally will not respond to subsequent treatments on older technology and nanosecond lasers, but do respond very, very well to the PicoSure® laser tattoo removal device.  SpaMedica attracts those Toronto laser tattoo removal patients that desire to have the best possible reduction in the appearance of their tattoo in the fewest number of treatments with the least number of side effects.  In addition, those individuals with multi-coloured tattoos or tattoos that have not been able to be successfully removed with lesser qualities of laser tattoo devices have gravitated to Dr. Mulholland and the SpaMedica laser tattoo removal program. Dr. Mulholland will also use ablative fractional lasers, such as the fractional CO2 and fractional erbium lasers to remove the faint, but resistant, faded tattoo ink and help facilitate the blending of the appearance of the tattoo.

Laser Tattoo Removal

Figure 10.  A.  Solid black Tattoo.  B.  The same tattoo after over 20 treatments at several centers with nanosecond 1064nm and 755nm lasers, but now with resistant or recalcitrant tattoo ink to the longer pulse duration nanosecond wavelength technology.  C. Same tattoo, 12 weeks after 6 treatments with the PicoSure™

I hear Dr. Mulholland and SpaMedica will sometime use Ablative CO2 or Ablative Erbium lasers on faded tattoos, does this work and how will it help?

Dr. Mulholland and SpaMedica will use fractional laser resurfacing, both ablative CO2 and Erbium as well as Fractional Radiofrequency needles resurfacing and non-ablative fractional infrared lasers to improve the appearance of multiply treated and faded tattoos. Sometimes some tattoos which are faded with little pigment may benefit from texture and color blending with fractional resurfacing.

Laser Tattoo Removal

Figure 11.  A Toronto Laser Tattoo patient with a muitlpy treated tattoo and near total removal. B .  Same tattoo after ablative and non-ablative fractional laser resurfacing.

Is there any maintenance required following laser tattoo removal?

There’s no specific maintenance required once the end point of the laser tattoo removal program has been achieved, which is almost complete eradication, no further maintenance need be required.  Some patients do elect to have another tattoo created over a tattoo that has been removed by a laser and this is possible approximately 12 weeks following your final treatment.

How much does laser tattoo removal cost?

In general, most tattoos, depending on their size, cost between $250 and $750 per treatment.  One of the big advantages of the SpaMedica laser tattoo removal program, the PicoSure® laser and the multiple laser tattoo removal system is that, on average,  only half the number of treatments are usually required compared to other, older laser removal technologies, making the whole process more affordable.

Why choose SpaMedica and Dr. Mulholland for laser tattoo removal?

Dr. Mulholland and SpaMedica have been pioneers in the area of laser tattoo removal.  No clinic in Canada has more experience removing tattoos using a laser and Dr. Mulholland has spared no expense to assemble the finest quality of lasers to ensure the best possible outcome with the least possible side effects in the shortest number of treatment times.

Dr. Mulholland is an acknowledged worldwide pioneer in laser tattoo removal and frequently lectures in the United States and around the world on behalf of Cynosure and other technology companies on the art and science of laser tattoo removal.

How do I schedule a laser tattoo removal consultation and a PicoSure® tattoo treatment program?

To schedule a consultation, simply fill out the on-page, e-mail consultation request form or call 877-211-7505 to speak to a customer service representative who will respond quickly to set up a consultation for you.  Call now to begin a tattoo-free you.

SpaMedica® YORKVILLE
Cosmetic Surgery and Laser Skin Care Spa:
66 Avenue Road Suite 4
Toronto, Ontario M5R 3N8
Tel: 877-211-7505