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Q-switched Lasers Can Leave Behind Scarred “Tattoo Remnants”

Sometimes I hear “laser technicians” brag about how many treatments they’ve done with their P.O.S. Q-switched laser.  I saw one the other day that said “over 250,000 treatments” performed.  You notice they don’t equate that to actual complete tattoo removals.  I see numerous patients that have had ten or more treatments and they’re left with horrible scars and residual ink that I call “tattoo remnants”.  Yesterday I saw one such patient who had lost count after she’d received 25 treatments!  That’s got to be the most I’ve ever seen.  Her scarred tattoo remnant is below for you to see.  Luckily for her, I will be able to remove the residual ink and break up the scar at the same time using the revolutionary PicoSure laser.  How is that possible?  Well, because the PicoSure pulses 100 times faster than a Q-switched laser it is much more effective and gentler on the skin.  You see, the slower a laser pulses, the more it heats up and damages the skin which results in scarring.  Fortunately, the PicoSure laser is also FDA approved for scar rejuvenation.

Scarred Tattoo Austin PicoSure Laser Tattoo Removal
Scarring from a POS Q-switched Laser – 25 Treatments!

The PicoSure laser is the best method available for safe, fast and effective tattoo removal.  No other instrument or treatment has been shown to be its equal.  In fact, most other methods are dangerous or will leave scarring and hideous residual ink.  If you’re living with a tattoo remnant and you’ve been treated numerous times without success, then you know just what I’m talking about.  If you’d like to finally get it off I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

White Ink & PicoSure Laser Tattoo Removal

Occasionally tattoo ink will turn dark in response to PicoSure laser tattoo removal. For this reason, cosmetic tattoos, often referred to as permanent makeup around the mouth and eyes, are usually avoided. The one exception to this rule is black permanent makeup applied to the eyebrows. If the look is too stark, it can be toned down with a PicoSure laser session or two. I’ve even removed black tattoos off the scalp which had been intended to look like hair follicles on a balding head – this is a very common tattoo camouflage technique and it’s performed by an experienced esthetician.

Sometimes white ink can turn dark when exposed to laser energy. Because of this, white tattoos are generally left alone. Besides, white ink is easy to cover up with a new design. But what if a standard tattoo includes white ink and the patient wants it off? Well usually I’ll treat around the white ink. If that’s not possible, such as in the example below, then a test spot can be performed to determine if the white ink is going to present a problem. Most of the time it will not turn black because the pigment simply reflects the laser energy. Take a look at the example below on a patient who is currently undergoing treatment.

White Ink Austin PicoSure Laser Tattoo Removal

The white is too diffuse in the design to go around it. I performed a test spot which showed no negative reactions and then treated the entire tattoo. Bottom line: some inks will darken upon exposure to PicoSure or Q-switched lasers. When in doubt a test spot should be performed. If you would like a complimentary evaluation and a no-cost test spot to see how your tattoo will respond to PicoSure I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

No Need For PicoSure – Beyoncé Launches Sexy Temporary Tattoo Line!

Hello Austin,

I’m back from a well-deserved vacation and ready to talk PicoSure laser tattoo removal once again. So, some exciting news regarding Bey and her new ultra cool temp tattoo line. Yes, Beyoncé, wife of rap star JAY Z, has teamed up with the folks at Flash Tattoos to help create sexy new temporary tattoos. While it used to be true that most temporary tattoos came in Cracker Jack boxes and were just for little kids, the art form has taken on a whole new persona to attract discriminating adults.

Now when you’re craving some new ink on Friday night, you can just lick it and stick it, then you’re headed to the club or pool looking cool as you want. Best of all, no more tattoo regret. And you can put these crazy designs anywhere! Now instead of coming to see me for PicoSure laser tattoo removal, you can just wash these off in a nice hot bath. You can see the whole line by clicking here: Beyoncé’s Tat Line

 Bath Austin PicoSure Laser Tattoo Removal v2

In the meantime, if you do happen to have some lingering doubt about one of your existing permanent tattoos and you want it safely and completely removed with PicoSure, I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

When Should We Not Use PicoSure Laser Tattoo Removal?

Is PicoSure laser tattoo removal for everyone?  The short answer is: no.  Unfortunately not all tattoos can be treated just as not all people can be treated.  Below is a list of contraindications for PicoSure treatment but the one that mostly affects my practice is pregnancy.  I have a policy that I do not perform PicoSure laser tattoo removal treatments on women who are pregnant.  In fact, the Med Spa I work in does not perform any laser treatments on pregnant women including laser hair removal.

Pregnancy Austin PicoSure Laser Tattoo Removal

While the vast majority of cosmetic laser treatments are safe and effective, we must, out of an abundance of caution, use sound medical judgment when determining who can undergo laser treatment.  The PicoSure laser has not been tested on pregnant women and therefore, there is no data to indicate that it is safe to do so.  I have had several patients halt their treatments after they became pregnant and then safely resume them once they had delivered.  I have also adopted the policy of no treatments while a patient is breastfeeding due to the slight risk of circulating ink contaminating breast milk.  While this would truly be a rare incident, nevertheless, we must be cautious where babies and new moms are concerned.  If you have a tattoo you would like removed with PicoSure, I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

Therapy using the PicoSure laser is contraindicated for those patients who:

  • Are hypersensitive to light in the near infrared wavelength region
  • Take medication which is known to increase sensitivity to sunlight
  • Have seizure disorders triggered by light
  • Take or have taken oral isotretinoin, such as Accutane®, within the last six months
  • Have an active localized or systemic infection, or an open wound in area being treated
  • Have a significant systemic illness such as lupus or an illness localized in area being treated
  • Have common acquired nevi that are predisposed to the development of malignant melanoma
  • Have herpes simplex in the area being treated
  • Are receiving or have received gold therapy
  • Are pregnant or breastfeeding (lactating)

PicoSure Lasers Utilize Invisible Light To Perform Tattoo Removal

PicoSure laser tattoo removal is performed with an invisible laser beam!  Huh?  Did you know that the 755nm Alexandrite beam cannot be seen with the naked eye?  So how do I know where the laser beam is aimed when I’m performing tattoo removal treatments?  Well the PicoSure comes with a laser pointer built into it like a gun site (see photo below).  When I point the red dot at a spot on a tattoo and press the foot pedal the PicoSure fires its invisible beam into the dermis.  The energy passes through the skin and destroys only the ink itself which means not only is the PicoSure more effective but the chance of side effects like burns or scars are significantly reduced when compared to a Q-switched nanosecond laser.

Sign Austin PicoSure Laser Tattoo RemovalPointer Austin PicoSure Laser Tattoo Removal

Interestingly, the new PicoSure laser handpiece for red, yellow and orange inks does emit a visible beam which is an intense green.  The reason for this is that red pigments are red because they absorb green light and reflect red light.  The green laser handpiece fires at a picosecond pulse interval which produces a powerful PressureWave.  This combination of energy and pressure destroys red and yellow pigment but is virtually harmless to the skin.  The result: it looks as though the area had never even been tattooed.  If you have a red, yellow, orange or multicolored tattoo you would like removed with the revolutionary PicoSure laser I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

PicoSure Laser Tattoo Removal Works Remarkably Well On Cover-Up Tattoos

Much of the PicoSure laser tattoo removal I perform is on cover-up tattoos.  Sometimes I get asked if this will make any difference in the overall removal.  The short answer is “no” but there can be some interesting complexity to it.  For example, was the original tattoo made in a friend’s garage using a home-brewed ink?  If so, the ink from the original tattoo may be more (or less) difficult to remove than the professional ink used in the cover up.  Why?  Because each type of ink utilizes different ingredients, pigments and additives. Think of it like the difference between pen and pencil; a pen is much tougher to erase than pencil.  Occasionally, as in the example below, the cover-up tattoo will come off first and reveal all or part of the original design beneath it.  Regardless, all of the ink will eventually be removed, albeit in layers.

Cover-up PicoSure Laser Tattoo Removal Austin TX Hall Plastic Surgery v2
Cover-up tattoo in the process of removal.

The layering of several differing inks can affect the speed of removal.  Remember that PicoSure laser tattoo removal is a physical process not a chemical process; there is no known chemical that can dissolve tattoo ink once it is in the skin.  It can take the body quite a while to physically engulf, absorb and remove millions of shattered ink particles.  In fact, I’ve documented two patients who continued to fade for over a year following their last treatment with PicoSure – both had moved away and later returned to Austin.  If you have a cover-up tattoo you would like safely and effectively removed with the PicoSure laser I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

Mummies Could’ve Used PicoSure Laser Tattoo Removal!

Do you have at least one tattoo?  You’re not alone – not by a long shot.  In fact, your oldest of relatives can be seen sporting ink.  The oldest known example of a tattoo comes from a 6,000-year-old Chinchorro mummy.  The Chinchorro culture is found in what we now call northern Chile and southern Peru.  In fact, many mummies from around the world have been found with tattoos, including a 5,300-year-old Alpine hiker dubbed “the Iceman” who had 61 tattoos made by rubbing charcoal into his punctured skin.  But not all of this artwork was decorative; it’s been speculated that some of these mummy tattoos are actually acupuncture markings designed to relieve pain.

Mummy Austin PicoSure Laser Tattoo Removal

Considering our inked up mummy ancestors, I believe that tattoo regret is somewhat of a newer phenomenon.  I doubt these ancient peoples desired tattoo removal at all.  In fact, they probably loved their body art as it meant a great deal to them.  Nowadays, with tattoo shops on every other corner, it’s much easier to make an impulsive decision that we will later regret.  Couple that with the fact that not all artists are equally talented and you’re left with a recipe for regret.  If you have a tattoo you’re regretting the PicoSure laser can help. I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX: Austin Medspa on W. 6th St.

PicoSure Laser Celebrates Its 2nd Birthday!

HAPPY 2nd ANNIVERSARY!  Wow, the PicoSure laser is celebrating its 2nd birthday this month.  It was officially released in April, 2013 and initially only 15 units were built.  As many of you know, I happened to get
one of those original 15.  In fact, the serial number on the PicoSure in my office is SN#115 which means I actually got the very last (the 15th) one built of that original release!

Well a lot has happened in these past 2 years.  I’ve performed hundreds of treatments on many, many of my fellow Austinites (those of us who live in Austin, TX) and visitors from all over the U.S.  Because I’m the only RN in our office to perform the PicoSure laser tattoo removals, I’ve become one of the most experienced providers in the mainland United States.  Several of my patients have been featured in PicoSure ads which highlight impressive removals and fades.  My techniques and removal strategies have become highly effective, which is critically important to a passionate healthcare provider.

I would like to thank the folks at PicoSure for their clinical expertise and technical support over these past 2 years but mostly I’m thankful for my patients who trust me to take the utmost care of them.  Being an RN is a responsibility that I take very seriously and I always feel honored when a new patient makes the decision to allow me to care for them.  I look forward to this next year working with you to remove or fade your unwanted ink.  If you ever get to Austin, TX I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.


PicoSure Lasers are Highly Effective at Removing Tattoos in Skin Types I-IV

It is always best to perform a test spot when a patient has a skin type which might respond poorly to PicoSure laser tattoo removal.  Patients with darker skin or those with a history of keloiding should approach laser tattoo removal with extreme caution due to the very real possibility of permanent hypopigmentation.

The color of skin is classified using the Fitzpatrick skin types scale from I-VI, with I being the lightest and VI being the darkest.  Most African Americans fall into the V & VI range while a Caucasian blonde with blue eyes who burns easily might be a I or II skin type.  When skin is very light the laser passes through it harmlessly and all of the energy of the pulse is absorbed by the tattoo pigment which is instantly vaporized and shattered in response to the PicoSure PressureWave.  The laser cannot pass through darker skin because its melanin is acting as a protective barrier to shield the tissue from UV radiation or sunlight.  If a laser makes contact with melanin it may cause permanent hypopigmentation.  Because of this, I do not treat skin types V & VI without careful consideration.  The risk for poor clinical outcomes is far too high.

Skin Type Chart

For all other patients, I exclusively utilize the PicoSure laser and the clinical results and outcomes are quite striking.  Thankfully, the majority of tattoos can be safely and effectively removed, leaving the skin looking as though it had never been inked.  The PicoSure laser is gentle on the skin, decreases the possibility of unwanted side effects and is proven to be more effective than Q-switched lasers.  However, each patient is unique and no set of treatment regimens work the same on all people.  This is why, when in doubt, a test spot must be performed at no cost to the patient.  If you have an unwanted tattoo but are concerned about your skin type and its response to the laser I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

Excision of a Tattoo Versus PicoSure Laser

Have you ever considered excision (surgery) for your tattoo removal?  Even the best plastic surgeon would be unable to remove a tattoo without leaving a surgical scar.  True, the scar would be quite fine and diminish over time but if your tattoo is large this may be impractical.  Why?  Because the scar must be longer than the length of the tattoo being removed.  Additionally, if the tattoo is quite wide as well as tall, the stress on the incision site might cause a less than perfect appearance (see example below).  Scars that don’t heal perfectly might require surgical revision later to reduce their appearance.

Click to enlarge photo:

Excision scar v2

Many plastic surgeons can easily remove minor tattoos and leave a small, discrete  scar.  This might be an option for those of you who need an immediate removal.  A good rule of thumb to remember though is that excision will always leave some form of scar, whereas tattoo removal with PicoSure will usually leave no trace.  In other words, the skin will look as though it had never even been tattooed.  If you have a tattoo you want excised or removed safely with PicoSure I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

Incomplete Tattoo Removal With Q-switched Lasers

Question: How many patients have undergone POS Q-switched laser tattoo removal treatments?  Answer: Millions.  Do you know what the success rate is for these Q-switched laser treatments?  Well without quoting an exact number, let’s just say it’s poor.  Why?   Because POS Q-switched lasers utilize very old and limited nanosecond technology which often leaves scars and residual ink in the form of unsightly tattoo remnants.  I see these folks almost every week asking me if I can fix their tattoo; get out the residual ink and improve the appearance of the scars.  My answer is always “Yes I can.”  The PicoSure laser is great at removing residual ink and it’s also FDA cleared for scar rejuvenation, which is fancy way of saying improves the appearance of scars.

So back to the original question; if millions have tried Q-switched lasers with a poor success rate, how many folks out there have been left with an ugly looking tattoo remnant?  Answer: probably hundreds of thousands, if not millions.  Take a look at the example below.  One treatment with PicoSure is all it took to fix this remnant.  Although this is a clinical trial photo, I have numerous examples in my own practice I could show you that turned out just as well or better.  At some point, if Q-switched lasers continue to operate unsuccessfully, there may be just as many people with tattoo remnants as there are with tattoos.  Fortunately, the word about the effectiveness of PicoSure has gotten out and discriminating patients are seeking them out for their safety and efficacy.  If you have a tattoo remnant or just a plain old tattoo you would like removed with PicoSure, I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.


PicoSure Laser Tattoo Removal on the Trunk and Legs

I once read a clinical paper on laser tattoo removal which noted that tattoos appear to come off easier in certain areas of the body.  The authors pointed out that tattoos on the trunk (back, chest) didn’t require as many treatments as say a tattoo on a lower extremity (leg, foot).  I have also found this to be true in my practice.  Some ankle tattoos can be more difficult to clear than upper back tattoos.  Why?  Most likely this is partially related to a circulatory issue.  Remember that much of the vaporized ink is cleared through the lymphatic system.  Clear fluid between the skin cells drains out through this network which is much like our cardiovascular circulatory system.  However, lymph fluid is not pumped by the heart.  Lymph vessels drain fluid by the compression action of our muscle tissues.  The structure of the lymph system follows the design of the body into external and internal regions.  Therefore, the drainage of the legs is much different than the drainage of the upper trunk.  There may be more lymph flow in our upper regions above the heart than in our feet depending upon our overall health, activity level and other factors.


Regardless of this issue, the PicoSure laser is still more than capable of removing the majority of lower extremity tattoos.  The location of a tattoo, along with its size, depth and color must all be factored in to the removal strategy.  Starting with the best tattoo removal laser available is a great first step.  If you have a tattoo on your ankle, back or just somewhere in between that you would like removed, I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

Wait Until You’re Fully Healed Before Beginning Laser Tattoo Removal With PicoSure.

New patients often ask me how long they have to wait to begin PicoSure laser removal treatments after getting a brand new tattoo.  A good rule of thumb is 4 weeks but this can vary by size, site, patient health and other factors.  For example, a small tattoo with little ink is definitely ready at 4 weeks but a large tattoo with delayed healing and tons of ink might not be ready for 6-8 weeks.  We must understand that each patient is unique and heals differently depending upon the site and size of the area that was tattooed.  Occasionally a person may have an allergic reaction to a particular ink which can delay healing even more.  Someone who is immunocompromised can similarly be delayed in healing.

Even though numerous patients wake up the next day and immediately regret their tattoo, it’s important to ensure the tissue is fully healed before exposing it to laser energy.  The health of the skin directly correlates to the removal process.  Even in a normal course of treatments a patient who doesn’t properly care for the treated area will experience a less than optimal removal.  Remember that much of the ink is transported away via the lymph system as it passes into the clear fluid between cells.  If this area is still clogged with debris following the tattooing process then the clearance is significantly diminished.


Lastly, even though a patient should wait 4 weeks before their 1st treatment there are still clinics that don’t adhere to this good rule of thumb.  Unfortunately, if you want a specific treatment quickly, the world is full of people who will oblige regardless of the risks.  If you need a professional, medical treatment please leave it to a doctor or nurse who is trained and certified in a particular area.  Better yet, give me a call and see what a difference there can be in laser tattoo removal with a professional, experienced PicoSure nurse.  I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

PicoSure Laser Replaces Nd:YAG as the New Gold Standard in Tattoo Removal

What’s an Nd:YAG laser and what does the acronym stand for?  Well here’s your answer: neodymium-yttrium-aluminum-garnet.  Wow, no wonder someone came up with an acronym, right?  Yttrium aluminum garnet (YAG) is a synthetic crystalline material of the garnet group (see photo below). YAG is commonly used as a host material in various solid-state lasers. Rare earth elements such as neodymium can be doped into YAG as active laser ions, yielding Nd:YAG.  So now that we know what it stands for, what do all those words really mean?  Here you go:

  • Neodymium: A shiny, silvery metallic element of the lanthanide series. It is used to make glass for welders’ goggles and purple glass for lasers.
  • Yttrium: A silvery metallic element used to strengthen magnesium and aluminum alloys, and as a component of various optical and electronic devices.
  • Aluminum: A lightweight, silvery-white metallic element that is ductile, is found chiefly in bauxite, and is a good conductor of electricity. It is the most abundant metal in the Earth’s crust.
  • Garnet: Natural garnet crystals are dodecahedral (12 sided polyhedron) in shape, transparent to semitransparent, and have a vitreous luster.  YAG lasers utilize synthetic garnets like those shown below.

NdYAGGarnetKTP Crystal

Q-switched Nd:YAG lasers also contain a potassium titanyl phosphate (KTP) crystal in addition to the Nd:YAG crystal, which doubles the frequency of the 1064nm laser light.  The result is both a 1064nm and 532nm wavelength at the relatively slow pulse speed (for lasers) of a nanosecond.  This allows for the photothermal clearance of some pigments but fires so slowly that often times the tissue is permanently damaged.  At one time, this was the only possible way to remove a tattoo besides excision.  A significant percentage of patients were left scarred or hypopigmented and with residual tattoo ink of previously untreatable colors such as blue, green, purple and recalcitrant black.

PicoSure lasers pulse 100 times faster than their POS Q-switched cousins and deliver both the 755nm and 532nm wavelengths to remove virtually all colors effectively without damaging the skin.  The picosecond pulse creates a PressureWave that courses through the skin and literally dislodges and shatters ink pigments in to the smallest of fragments which can be readily absorbed and removed by the body.  If you have a colorful tattoo you would like to remove completely or simply fade for a fresh new cover up, I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

PicoSure Laser Tattoo Removal Requires a Prescription

Who’s performing your laser treatments?  Did you know that only a qualified doctor can prescribe laser treatments for tattoo removal?  In fact, just the purchase of a PicoSure instrument requires a doctor’s order.  However, the doctor may delegate the application of laser treatments to a professional that they supervise.  Have you ever wondered why the FDA requires a physician’s order for certain medications or treatments?  Well it’s because there’s a real danger in allowing the average patient to diagnose and prescribe treatments for their various ailments.  It takes years of training and experience to understand the human body and how its various mechanisms act and interact with one another.


Take laser tattoo removal for example, there are serious risks associated with the procedure.  Known risks include: burns, scars, infection, pigmentation changes and less than an aesthetically pleasing result.  I have had numerous patients come to me with these side effects which were brought about by improper treatment.  Most of the time I’m able to help remove the remaining pigment and improve the appearance of the scar tissue but occasionally there’s not much that can be done to help the patient.  Unfortunately, the limitations of POS q-switched lasers often have providers applying too much energy in an attempt to remove a blue, green or recalcitrant ink that they’re incapable of removing.  If you’re living with a remnant of ink or an unsatisfactory result after having undergone q-switched laser tattoo removal you probably know just what I’m talking about.

Fortunately, the PicoSure laser minimizes the potential for side effects because it pulses so quickly that the ink is shattered but the surrounding skin is undamaged.  Does your provider utilize the PicoSure laser or are they still using a laser with older q-switched technology?  If you’ve been injured by a POS q-switched laser or want to remove your residual ink from previous treatments, I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

PicoSure Versus Q-switched Nanosecond Lasers in Tattoo Removal

What are the main differences between the revolutionary PicoSure and standard POS q-switched nanosecond tattoo removal lasers?  Well for starters, the PicoSure achieves better clearance in fewer treatments.  Fewer treatments equates to:

  1. Faster clearance
  2. Less cost
  3. Better clinical outcomes
  4. Less risk of dermal injury and scarring

Take a look at one of the clinical trial photos where the PicoSure laser went head to head with the best q-switched laser available.  Both sides of the same tattoo were treated; one with PicoSure and the other with a q-switched laser.  The results are astonishing and speak for themselves.

Head to head

One other important distinction between the PicoSure and POS nanosecond q-switched lasers is the speed of the pulse.  This unparalleled breakthrough in laser technology delivers ultra-short pulse bursts of energy to the skin in trillionths of a second.  A picosecond pulse width is 100 times shorter than nanosecond technology, enabling unmatched photomechanical impact for better clearance with fewer treatments and less fluence (energy).  Less energy means less damage to the skin.  If you are interested in safe, effective tattoo removal for less money and faster results, I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

Getting to Know the PicoSure Laser for Tattoo Removal

Patient education is an important part of making the decision to undergo PicoSure laser tattoo removal.  During the initial consult and before each treatment patients are encouraged to ask questions, look at their before and after pictures or discuss the treatment strategy. When you and your PicoSure provider are on the same page there’s greater understanding of the process and potential outcomes of each treatment. For example, it’s my responsibility to help teach you how to care for your treatment area once you leave the office. The tattoo will undergo several distinct phases and proper care throughout the healing process helps ensure you’re ready for the next treatment and that your skin stays healthy as the ink is being removed.

Occasionally we’ll discuss the various PicoSure laser settings used to fine tune a treatment. Just like snowflakes, every tattoo and individual is unique so each treatment is tailored to maximize removal and minimize the potential for side effects. Take a look at our actual PicoSure laser below. It’s one of the first 15 units that were built and shipped by the manufacturer. I’ve labeled the primary components and controls. The user interface is the multicolored touch screen on the top front. This is where the operator inputs your treatment settings. However, spot size, which is the diameter of the laser beam, is adjusted by turning the handpiece. By making the spot size smaller we increase the amount of energy delivered to the tattoo which is measured in Joules per centimeter squared (J/CM2).

This is just a cursory overview; laser technology is highly complex and fascinating. It’s important that your provider truly understands the various settings and the proper techniques for application to ensure the safety and efficacy of the treatments. If you have a specific question for me regarding laser tattoo removal you can email me at the address below.  If you just want to get rid of your ink, I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

Click to enlarge.

PicoSure Laser Pic with Labels

Imiquimod Cream is Not Effective in Tattoo Removal

I routinely get asked the question “What else can I do in between PicoSure treatments to make my tattoo ink clear faster?”  My answer is that cupping therapy is the only thing that’s been shown to effectively help remove tattoo ink during the course of PicoSure laser treatments (please see my cupping therapy results and articles).  Researchers have looked at several other possible therapies that might speed up or improve the process of laser tattoo removal but unfortunately these have all run into dead ends.  One such clinical trial explored the use of a prescription-only topical agent called Imiquimod cream which is an immune response modifier.  Imiquimod is sold under the brand names Aldara and Zyclara and is used primarily to treat genital warts and certain skin cancers.

In 2007 Ricotti, C.A. et al wrote a paper involving a clinical trial with Imiquimod cream as an adjunct therapy to laser tattoo removal.  The study involved 19 patients and the conclusions were that Imiquimod cream did not produce a significant improvement in ink clearance.  Since Imiquimod cream has been proven useless in tattoo removal and it is a powerful drug capable of causing serious unwanted side effects, including scarring, pain, inflammation and dermatitis, it is never prescribed for our tattoo removal patients.  For now, we exclusively utilize the PicoSure™ laser on all of our tattoo removals and our clinical success rate and results are quite amazing.  No high risk adjunct therapies are required due to the outright effectiveness of the picosecond pulse at creating a PressureWave™ capable of breaking up even the toughest of ink.

If and when another effective adjunct therapy is discovered and the appropriate clinical trials are conducted, we will implement it at that time.  Until then, the safest, most effective method for tattoo removal is the PicoSure laser in the hands of a skilled clinician with cupping therapy used in between.  Patients must understand that tattoo removal is a process that can take many months to complete but when it’s performed correctly, the results can be beautiful.  If you would like to discuss your potential options and strategies for laser tattoo removal with PicoSure, I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

PicoSure Laser Tattoo Removal – Are Package Deals Really a Deal?

You wouldn’t believe the number of patients who come to my office and tell me how another provider refused to treat them unless they purchased a “package” of POS q-switched or PicoSure laser tattoo removal treatments.  This happened again today and I was shocked to learn the patient was told she would have to buy 8 treatments for a blue tattoo remnant that was roughly 1 square inch in size.

LB 1-29-15

The tattoo had been previously treated 10 times! with a q-switched laser that was, of course, ineffective on blue ink of this type.  After examining the patient and her tattoo we discussed the possible risks and benefits of PicoSure laser tattoo removal.  I explained to her that I treat many recalcitrant tattoo remnants of blue, black, green and purple colors routinely.  Although I couldn’t promise how quickly this particular tattoo would clear, I did tell her that I didn’t think more than 2 treatments, if that, would be required.  This opinion was based upon my personal experience in operating the PicoSure laser every day since it was first launched by Cynosure approximately 20 months ago.  In other words, there’s absolutely no way this lady would ever need a package of 8 treatments.

Package deals in photofacial and laser hair removal are quite common; however, they might be counterproductive in tattoo removal where each treatment might be the last you will ever need.  I have heard of providers offering “unlimited” laser treatments until “your tattoo is gone”.  Really?  Who would subject their body to unlimited laser treatments?  If it’s not working, if the tattoo is not progressing, then stop treatment and have a conversation with your doctor about a new and proper course of action.  If your tattoo has stopped responding but you’re tied in to a “package”, please give me a call or an email and I’ll see what we can do to get you back on track and finally remove that tattoo.  I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

PicoSure Laser – “Light Amplification by Stimulated Emission of Radiation”

PicoSure vs. Q-switched

The technology behind medical lasers is incredible and the PicoSure laser for tattoo removal is no exception.  It was the first compact medical picosecond laser to be developed.  Researchers had known for quite some time that POS Q-switched nanosecond lasers fired too slowly to produce an effective PressureWave that could break up tattoo ink.  What’s more, the standard Q-switched lasers available at the time were likely to cause collateral tissue damage, burns and scarring, when employed for tattoo removal in resistant, tough or colored inks like blue and green.  You may know this personally if you’re still living with a blue or green tattoo remnant.  The answer was to build a laser that could target colors and fire a pulse in a trillionth (pico) of a second.  The result was the PicoSure laser and it has more than lived up to expectations.  It is the first and only FDA cleared picosecond laser and it’s the only laser that I will use for tattoo removal because of its superior clinical results.

Recently, the manufacturer of the PicoSure laser released a software upgrade called Boost which shortens the pulse duration even more.  This makes the laser fire faster which results in an increase in the PressureWave of up to 70%.  In my experience, Boost has improved the performance of what was already the best laser available for tattoo removal.  I have treated many recalcitrant tattoos with Boost and the patients are pleasantly surprised at how effective the laser is at removing residual ink in tattoos that had previously been treated elsewhere 10 times or more.

There are two different mechanisms at work here (1) photothermal and (2) photomechanical (please see image above).  Photothermal is the process of heating ink particles and photomechanical is the effect of the PressureWave literally breaking the pigments apart in to the smallest of sizes which can be easily carried away by the body.  The lasting effects on the skin are minimal whereas the tattoo itself is permanently destroyed and removed.

Besides the Boost upgrade, there have been other revolutionary upgrades to the PicoSure laser since its release in April 2013.  Advancements include the detachable Focus Lens Array for pigmentation removal and tissue rejuvenation as well as others pending FDA clearance.  I’ll try my best to keep you up to date on further developments so stay tuned for more information on just how this innovative laser might be able to help your particular situation or condition.  Want to discuss your unwanted pigment or ink?  I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

How Many Treatments Does PicoSure Take to Remove a Tattoo?

Probably the most asked question I hear regarding PicoSure laser tattoo removal is “How many treatments do you think this will take?”  The truth is no one can promise a patient how fast a tattoo will come off.  I do often give my impression based on the size, location and colorization of the inks.  However, until I see the ink respond, it’s just impossible to know.  Here’s some good news though, I’ve taken off 3 tattoos from three different people in a single treatment!  One was a set of initials over 60 years old, another was 2 blue dots by the patient’s thumb and the last was a green tattoo remnant on the lower leg which had previously been treated more than a dozen times with an ancient POS Q-switched laser.

So the short answer is that most tattoos will take between 1-10 treatments to remove completely with the PicoSure laser.  The last couple of treatments are just to touch up stray lines and dots which were put in extra thick.  If you would like to get my best educated guess on how many treatments your tattoo might take, send me a pic to  I can also be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

Little Mistakes – Affordable Tattoo Removal With PicoSure

I often see patients who have made “little mistakes” and gotten small tattoos, on impulse, often at age 18, and regretted their decision almost immediately.  Unfortunately, for these folks most PicoSure providers charge a premium, regardless of tattoo size, and these little mistakes can cost an arm and a leg to remove.  In truth, the majority of folks seeking tattoo removal would find $400-$1,000 per treatment extremely cost-prohibitive.

Fortunately, our PicoSure laser sits right in the middle of a full service Med Spa in Austin, TX and our cost structure is such that we don’t mind making state-of-the-art tattoo removal affordable to virtually anyone.  Now that little mistake can be easily erased and forgotten.  We are the lowest cost PicoSure provider because (1) the treatments are relatively quick and (2) we want to make exceptional tattoo removal routine rather than rare.  If you want to remove a little mistake, or a large one, I can be reached  by phone @ 512-479-9997  or just stop by my NEW location in Austin, TX:  Austin Medspa on W. 6th St.

Remnant Tattoos Following Q-switched Laser Removal

I often see patients who have undergone numerous laser tattoo removal treatments only to be left with a lot of colorful ink remaining in the form of a blue, green or purple remnant.  The remnants are often scarred, hypopigmented or both.  This phenomenon is due to the fact that prior to the advent of the PicoSure laser, these colors were nearly impossible to remove with the existing Q-switched lasers that have been in use for decades.

Remnant B&A

Unfortunately, patients and their practitioners continued treatment even though no further fading was evident or even possible.  This leaves the skin in poor condition and increases the risk of permanent unwanted side effects.  Fortunately, the PicoSure laser is able to remove this residual ink even when it is bound by scar tissue.  In the process, the scars themselves may flatten out and soften.  The ability of the PicoSure laser to improve skin appearance (rejuvenation) has many practitioners using it for this purpose in addition to tattoo removal.  Not only can it remove unsightly pigments but it can significantly improve the texture and appearance of the skin.


Please call Brendan @  512-327-5337

PicoSure Laser – Austin, TX

The PicoSure laser can be used on virtually any part of the body in order to remove tattoos, including the upper and lower back, neck and hands.  I have successfully removed tattoos from virtually all areas of the body, including the face, bikini area, feet, toes, fingers, etc.  The chances are good that most tattoos can be removed without a trace but all inks are different and may respond differently to the PicoSure laser.  The type of ink used is more indicative of successful removal than is the age of the tattoo.  An old tattoo with a stubborn ink will come off more slowly than a new tattoo with weak ink and vice versa.

AD B&A 7-17-14


I can be reached in Austin, TX  at my new location inside Austin Medspa @ 512-479-9997.

PicoSure Brochure for Tattoo Removal

The PicoSure Laser I use was manufactured by Cynosure.  This company provides elite clinical training and support; I’ve attended several of their classroom education days which focused specifically on PicoSure.   If you would like more information on the PicoSure Laser for tattoo removal you can download one of their brochures by clicking the link below.  One of my patient’s before & after photos are featured in the brochure.


I can be reached in Austin, TX  at my new location inside Austin Medspa @ 512-479-9997.

PicoSure Brochure