Richmond, Virginia is the 3rd most tattooed city in America according to, and the demand for tattoo removal has exploded in the past several years. There are a number of reasons men and women may seek tattoo removal. The reasons can range from deeply personal issues such as a relationship breakup to the need to find a new job. Often times employers or the military may require new employees to remove visible tattoos in order to obtain a position. At Richmond Aesthetic Surgery and at our Dermlounge medical spa, Dr. Neil J. Zemmel will attend to your individuals needs and give you the most complete tattoo removal possible. In fact, at our Richmond, Virginia plastic surgery practice and medical spa, laser tattoo removal is the most common laser procedure performed. With the newest lasers available Dr. Zemmel is able to treat patients in an efficient and effective manner with little to no downtime or side effects.

Your Consultation

You will meet with Dr. Zemmel during your initial consultation. A full medical history and focused physical exam will performed focusing on the area of the tattoo. The location, size, shape, coloration, and skin quality will all be assessed. Once it is determined that you are a candidate for laser tattoo removal, a quote outlining the fees will be given. If you wish to proceed you will schedule a first treatment at your convenience.

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The Method of Laser Tattoo Removal

At Richmond Aesthetic Surgery Dr. Zemmel uses a Q-switch:YAG laser that is the “gold standard” for tattoo removal. Other lasers are available, but the Q-switch:YAG has the widest color spectrum and deepest penetration for most tattoos. This type of laser uses highly concentrated, columnated colored laser light that is targeted directly at the tattoo ink pigment. Each color within the tattoo is specifically targeted, leaving the surrounding skin nearly unaffected. This produces the minimal amount of damage to the surrounding tissues and reduces side effects dramatically. The laser not only breaks up the ink in the dermis but also pushes the ink to the surface of the skin for further clearance. Your natural immune cells then digest and dispose of the ink fragments through your immune system. With each treatment deeper layers of ink within the dermis are targeted to eventually dissolve all visible ink. Most tattoos take 6-12 treatments for complete resolution, and each treatment is performed 4 to 8 weeks apart.

Laser tattoo removal is a non-invasive surgical procedure but should be performed by a Board Certified Plastic Surgeon with a Plastic Surgery Physicians Assistant. By performing your procedure in a controlled medical environment, Dr. Zemmel is able to provide you with the safest and most effective treatment available.

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Factors Determining the Success of Laser Tattoo Removal

The success of laser tattoo removal depends on a number of factors including the size, location, and coloration of the tattoo. In general, the smaller a tattoo, the easier it is to completely remove. Larger tattoos such as full arm sleeves or tattoos covering the entire back will require a longer time and more treatments than a small tattoo on the shoulder blade for example.

The location on the body is also an important factor. The thickness of skin and dermis varies dramatically throughout the body. The skin of the forearm is thin compared to the skin on the back. Therefore tattoo pigment on the back maybe located at a much deeper level and require a more aggressive treatment with a longer healing time. In other cases, thin skin may scab or blister after a laser tattoo removal. Tattoos on the ankle have a higher risk of complications due to the thin skin covering this area. Your response will vary depending on these factors.

The laser tattoo removal works best on black, blue, and red pigment because these pigments have a relatively simple absorption spectrum. The laser targets these pigments easily allowing for a quicker removal. More difficult ink colors include green, turquoise, and yellow. Although these colors are more difficult to remove and may require more treatments, at least partial removal is possible is most cases.

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Your Procedure

All laser tattoo removal patients are offered a topical lidocaine (a local anesthetic medicine similar to Novacaine) dressing before each treatment. The medicine will be allowed to take effect for at least 30 minutes prior to your procedure. This will ensure you are as comfortable as possible and will minimize any discomfort You will then be positioned on the procedure room table depending on the location of the tattoo and special glasses will be given to each person in the room to protect the eyes from laser light. Treatments will take between 15 seconds and 15 minutes depending on the size of the tattoo. A credit card sized tattoo takes approximately 30 seconds for a complete treatment. For your additional comfort we also cool the skin with cold air immediately after each laser pulse. You will be given an ice pack after the treatment to decrease the risk of redness and swelling to the surrounding skin. A triple antibiotic dressing is then placed and post care instructions are given to each patient.

You will then be scheduled for your next treatment four to eight weeks later.

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Side Effects from Tattoo Removal

Most patients will experience a sunburned look to the treated area for approximately one week after the procedure. It is also common to experience mild blistering, especially after the first, second, and third treatments as the amount of tattoo ink is greatest. As more ink is dispersed the risk of blistering decreases. Other complications include hypopigmentation (lightening) and hyperpigmentation (darkening) of the surrounding skin, and as with all lasers there is also a chance of scarring after multiple treatments. These effects happen in the vast minority of patients.

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Other Options for Tattoo Removal

Laser treatments are currently the first line treatment for tattoo removal. For extremely small tattoos or tattoos not responsive to laser removal, other options may be available. Surgical excision (removing the skin) of the skin containing the tattoo is an option for tattoos in areas where excess skin may be found for direct closure of the area. An older, less desirable option is dermabrasion where the tattoo can be sanded off with a burr. This treatment usually leaves significant scarring and is almost never performed today as better, less invasive options are available.

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Your Results

The results for tattoo removal vary from patient to patient and can range from moderate lightening of the tattoo to complete removal with little trace of the original pigment. The factors including location, size, shape, and color will all affect your final result. The type of pigments used by the original tattoo artist varies from artist to artist and certain pigment are more difficult remove. This is usually due to the chemical composition of the pigments themselves.

Please be aware that multiple treatments will be necessary over several months to remove your unwanted tattoo. Dr. Neil J. Zemmel will take excellent care of you during this process.

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Contact Dermlounge

For more information on laser tattoo removal, or to schedule a consultation at Dermlounge, please contact us today.