A tattoo is a permanent pigmentation due to the presence of exogenous pigments more or less deeply in the skin. It can be done: Intentionally, with: Decorative purpose, associated or not with specific meanings; Make-up purpose, more often on the eyes, eyebrows and lips; Medical purpose, for example to facilitate positioning identifying areas to irradiate in radiotherapy treatments. Inadvertently, for example following trauma with penetration of pigment into the skin, most commonly tar. Currently, almost all tattoos have decorative purposes and are done with the intention of being maintained throughout life. However, with the generalization of its use, more and more people want to remove their tattoos , for example because they: Lost their meaning; No longer have the original appearance; Alter body image undesirably; Interfere with personal or professional life; Are no longer necessary. It may also be necessary to remove a tattoo when there is an allergic reaction to the pigment, or an infection develops at the tattoo site. What you need to do and should know A detailed prior medical evaluation is essential before deciding on the treatment to be carried out to remove a tattoo. There are multiple factors to consider, not only related to the technique that will be used, but also to individual factors, for example: Location of the tattoo on the body; Extension and depth of the tattoo on the skin; Characteristics of each person skin; Type of pigments and colors that were used in the tattoo; Age of the tattoo; Experience of the tattoo artist, which is related to the depth of the tattoo on the skin. How are tattoos removed? There are 3 main ways to remove tattoos: Laser; Dermabrasion; Surgical excision. The doctors who perform these procedures are most often plastic surgeons and dermatologists . Laser tattoo removal The use of lasers to remove tattoos is not new and it is a safe and effective procedure, especially for superficial tattoos . There are several types of laser, not all are suitable for removing tattoos; The use of an incorrect laser or the incorrect use of a suitable laser can cause irreparable damage; The same type of laser does not work the same way on all tattoos; Tattoos with different colors may require different types of lasers; This procedure requires several sessions, and it is not possible to guarantee in advance that the tattoo will disappear completely. Laser tattoo removal is usually performed under local anesthesia. Removal of tattoos by dermabrasion Dermabrasion allows the precise removal of the superficial layers of the skin using an abrasive device , until a depth is reached where there is no longer any tattoo pigment. Dermabrasion is not suitable for tattoos where the pigment reaches deep layers of the skin; It may take several sessions of dermabrasion to remove a tattoo; Recovery takes time, it can take more than a month; Dermabrasion is performed in an operating room, under local or general anesthesia, depending on the extension of the tattoo to be removed. Removal of tattoos by surgical excision Surgery, regardless of the technique adopted , allows the complete removal of a tattoo . It is a very effective method, regardless of the depth at which the pigment is deposited. Since it involves leaving scars, it should be performed by plastic surgeons with experience in cosmetic surgery . Depending on the extent of the tattoo, removal can be done by: Excision and local plasty using tissues surrounding the tattoo to cover the defect left by the removal. It may involve several surgeries in sequence for bigger tattoos, situation called a serial excision. Most often, excision and local plasty is performed under local anesthesia; Excision and plasty with skin graft harvested from another region of the body . This technique allows the removal of more extensive tattoos, but also leaves more extensive scars than other surgical procedures. It is usually done under general anesthesia; Excision and tissue expansion , in which the temporarily use of a skin expander is necessary. The expander is a silicone bag that is placed under the skin adjacent to the tattoo and is filled weekly with serum. This technique always involves two operations, which can be performed under local or general anesthesia. Remember It is always simpler to get a tattoo than to remove it completely. Regardless of the method – laser, dermabrasion or surgical excision – it is not possible to completely avoid leaving scars or guarantee that complications such as an infection or discoloration or darkening of the skin will not occur . To make sure you choose the right method and to minimize complications, it is essential to resort to experienced specialists and carry out these procedures in places that guarantee all technical and safety conditions . Not always the simplest method is the most effective. Not always the shortest route is the best way to reach a destination. Author : Alberto Rocha Pereira Meet the reconstructive and aesthetic plastic surgery clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
