How I do it
TATTOO REMOVAL JON D. PERENACK MD, DDS Adjunct Associate Clinical Professor and Fellow Director of Facial Cosmetic Surgery, Department of Oral and Maxillofacial Surgery Louisiana State University-New Orleans,
EXAMPLES OF VISUAL ARTISTIC EXPRESSION were present present in the excavations of the earliest sites of human culture. While etchings in stone have tremendous longevity, less stable human remains from as early as 5000BC have revealed tattooed skin, which is an artistic expression. Tattooing of the skin continues to have popularity and significance across all cultures today. As it might be expected, there are times when individuals might wish to remove a tattoo, possibly due to a change in meaning to the individual, an association with an unpleasant memory or a relationship, in order to make “space” for another tattoo, or just a casual whim.
1 Patient preop: Fitzpatrick two, professionally performed tattoo displaying primarily black/blue coloring, but also sub-levels of red and green pigment.
Contemporary tattoo removal typically involves the use of quality-switched (QS) lasers capable of delivering pulses of chromophore directed energy in the nanosecond range. These are QS Nd-YAG, QS Ruby, and QS Alexandrite lasers. These short pulse durations allows the pigment of the tattoo to be heated causing fragmentation, while being less than the pigment’s thermal relaxation time, thus minimizing heat transmission to the surrounding tissues. Fragmentation of pigment then allows the pigment particles to be removed by the patient’s activated inflammatory response. The control of heat dispersal aids in avoidance of blistering, hyper and hypopigmentation, scarring, and thickening of skin. The most recent QS Nd-YAG lasers that came to market, are capable of delivering energy in the
March 2022
2 Tattoo after 3 treatments with pico QS Nd-YAG laser on 1064nm setting. Plan for treatment with pico QS Nd-YAG with KTP on 532nm setting.
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