Gallery Archives

Modern Inks Require Redefining The Term “Recalcitrant Tattoo” – #PicoSure!

One of the questions I get most often is “How many treatments do you think I’ll need?” If you combine that question with the fact that as many as 50% of the new consults I get have been previously treated with some POS Q-switched laser it speaks to the matter of effective clearance.  Proper clearance means that the area looks as though it was never even tattooed.  Currently, when a tattoo still has visible ink after 10 or more treatments, it is considered “recalcitrant” – meaning hard to remove.

FACT:  I remove recalcitrant tattoos that have been previously treated unsuccessfully with POS Q-switched lasers, regularly!

I’ve often wondered about that nice round number 10. It was probably coined back in the eighties when tattoo removal was much simpler and revolved around clearing India ink and other weak pigments.  Today, modern tattoo inks are extremely resilient and lightfast.  Manufacturers have gone to great lengths to add chemicals and metals to their pigments which make them both brilliant in coloration and unfortunately, difficult to remove.  There are many patients out there who have had 20 or more treatments – including some of the patients below!

So what does this all mean? It means that the term ‘recalcitrant tattoo’ most likely needs to be redefined to something more realistic, based upon the reality that tattoos are inked with much tougher pigments than before.  The answer?  PicoSure!  While it’s true that tattoos are harder to remove, the PicoSure laser with Boost and its PressureWave can destroy and clear even the toughest inks made.  If you have a supposed recalcitrant tattoo that you’ve tried to remove unsuccessfully, don’t get a cover-up until you see me.  Chances are very good that I will finally remove your unwanted ink once and for all. 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 below to view these ‘Recalcitrant Tattoo’ images which were all UNSUCCESSFULLY treated by a POS Q-switched laser in some tattoo removal ‘clinic’:

Scarred Tattoo Austin PicoSure Laser Tattoo Removal     Eyelid Austin PicoSure Laser Tattoo Removal     LB 1-29-15

PicoSure Laser Tattoo Removal May Be Successfully Used On Many Different Body Parts

I always enjoy meeting new patients for the first time, hearing their stories and examining their unwanted tattoos. As you can imagine, I’ve seen and heard quite a lot since the introduction of the revolutionary PicoSure laser for tattoo removal.  Some of the stories are pretty moving and many of the tattoos have an interesting history.  Sometimes, the tattoos are where you wouldn’t expect to find them.  I met one such patient yesterday, who had an interesting story and an accompanying tattoo in an odd location.  He had lost his left eye when a friend shot him with a BB gun.  He wore an eyepatch for years and then decided to get a tattoo on his eyelid of a small rose.  Like millions of other people, he wound up regretting that decision and got numerous treatments with a P.O.S. Q-switched laser (there’s a lot of them out there).  Unfortunately, the treatment results were poor at best.  So now he’s left with an obvious aqua-blue tattoo remnant on his eyelid.  Fortunately for him, I have removed numerous remnants left behind after a patient has been treated by a “technician” with some P.O.S.  He had his first treatment today and I’ll post an after picture when the ink is cleared.  Until then, if you have a tattoo in an odd location that you would like to finally be rid of, 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.

Eyelid Austin PicoSure Laser Tattoo Removal

Austin PicoSure Laser Tattoo Removal Of Red & Yellow Ink With 532nm Wavelength Handpiece

As the first PicoSure laser in the entire Southwestern U.S. to have the 532nm optional upgrade handpiece for red, yellow, pink and orange inks, I would like to give my impression as to its performance. Originally, these light colors on the front end of the ROY G BIV rainbow spectrum, were tough to remove due to their low photosensitivity. The PicoSure team compensated for this by releasing an optional handpiece that emits a 532nm green wavelength laser beam. Red inks appear red because they absorb green and reflect red. By absorbing this 532nm green light, the ink’s weakness is exploited and they fracture into the tiniest of particles which can easily be removed by the body via the lymph system and its circulating lymphocytes.

Red - Yellow Austin PicoSure Laser Tattoo Removal

In the photos below we can see the frosting reaction when the new 532nm handpiece is used on a light red and deep yellow ink. This phenomenon is virtually impossible with a standard PicoSure laser which is why I went through the time, expense and training to receive one of the first four 532nm handpieces ever built. If you have a tattoo that includes red, yellow, pink or orange that you would like completely and efficiently removed with the PicoSure laser tattoo removal system, 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 Of A Tramp Stamp

Women have been subjected to many derogatory terms over the years and the phrase “Tramp Stamp” is no exception. The lower middle back is a great place to hide a tattoo but unfortunately, any woman who got inked in that location is now labeled a tramp?! That’s not cool. Some folks have tried to correlate tattoos to risky or risqué behavior by doing so-called research in to the habits of women with tattoos. Well I find the term ‘Tramp Stamp’ offensive and misleading. Think about this: 61% of U.S. females 18 years old and up have a tattoo. Are you trying to tell me that the majority of women are tramps? I don’t think so. I remove tattoos on a daily basis with the PicoSure laser and the results are striking and frankly, incredible. There are all sorts of reasons why women want to remove their tattoos: an old flames name, too visible for work, etc. But increasingly, women are using the PicoSure laser tattoo removal system to clear away ink that they believe society judges them for. That’s too bad but I guess it’s the world we live in today; even in a nonjudgmental town like Austin, TX. Whatever the reason, if you want your lower back tattoo 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.

Tramp Stamp Austin PicoSure Laser Tattoo Removal

532nm Handpiece Arrives For PicoSure Laser Tattoo Removal Of Red & Yellow Inks

It’s here!  I’m the first in Texas and all of the Southwest to receive the new 532nm handpiece for the PicoSure laser which is used to specifically remove red, yellow and orange tattoos.  I acquired this somewhat costly new attachment in order to provide patients’ with the best technology available as part of my commitment to quality laser tattoo removal. The PicoSure laser 532nm handpiece emits a powerful green laser light which is highly absorbed by red & yellow inks and their variations like pink and orange.  It’s interesting to note that red appears red because it absorbs green and reflects red light.  This means that the green-colored laser beam energy produced by the new handpiece will be absorbed by red tattoo pigments and cause them to fragment.  Then the PicoSure PressureWave will further destroy the ink by shattering it into the smallest of particles which can be easily removed by the body.

532 v2 Austin PicoSure Laser Tattoo Removal532nm Austin PicoSure Laser Tattoo Removal v2

The handpiece will be installed onto the PicoSure platform this week and fully calibrated to ensure safety and efficacy.  Next week, I’ll personally attend a PicoSure training and educational event to ensure that I am highly qualified to operate the new 532nm handpiece and understand its various settings and technical specifications.  Proper education, training and experience are paramount within the healthcare setting because I believe that patients’ deserve the finest care possible.  If you have a tattoo removal that requires destroying red or yellow ink, or one of their colorful variations, and you would like it safely, quickly and professionally removed with the brand new, state-of-the-art 532nm PicoSure handpiece, 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.

Permanent Eyebrow Tattoos May be Removed or Lightened as Needed by the PicoSure Laser

Should the PicoSure laser be used for permanent makeup tattoo removal?  Years ago a famous actress by the name of Lana Turner shaved off her eyebrows for a movie role and they never grew back!  She eventually had false stick-on eyebrows made that she wore for the rest of her life.  Her other option would have been to have eyebrows permanently tattooed above her eyes by a skilled master artist.  In fact, nowadays permanent “cosmetic tattoos” are quite popular; especially for the eyebrows.  Another option for patients who have thin or nonexistent eyebrows is hair grafting but it can be costly.

Permanent makeup consists of tattoos that are usually applied by a skilled esthetician who has received special training.  The most common procedures include eyebrows, eyeliner and lips.  Given the amount of time it takes to put makeup on every day, many women decide to take the plunge and get it done once by a professional.  They wake up every morning with perfect make up and their friends and family never see them without makeup on.  However, just like any tattoo a person can change their mind or get tired of a particular ‘look’.  Then what?

Eyebrow - Austin PicoSure Laser Tattoo Removal Hall Plastic Surgery

The pigments in permanent cosmetics are different than standard tattoo inks.  Colored lip liner, lipstick and eyeshadow may actually turn black, change colors or darken significantly when exposed to a laser.  Therefore, most clinicians will not treat permanent makeup because the risk is too great.  Additionally, the location around the eyes further complicates the treatment.  One exception is permanent eyebrows; because the ink is already quite dark, the risk of it becoming even darker is minimal.  I’ve successfully treated a number of ladies with permanent eyebrows because their artist didn’t quite achieve perfection.  Sometimes eyebrow tattoos appear too stark or too dark.  The shape may not match the patient’s face or there’s not enough symmetry.  Whatever the reason, PicoSure laser tattoo removal can help.  If you have permanent eyebrows you would like to soften or lighten 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.

U.S. Army Tattoo Removal Policy and the PicoSure Laser

Just an Austin PicoSure laser update from the U.S. Army on its relaxation of the tattoo standards for new and existing recruits:    As I reported earlier this year, the Army has modernized its year-old policy which had previously forbid large tattoos below the elbows and knees.  The restrictive measure had discouraged solid recruits from enlisting and it also was unpopular with existing soldiers who were thinking about quitting because of the severe tattoo policy.

In addition to the changes noted above, the Army now says that it will also stop its annual cataloguing of a soldier’s ink.  Previously, under AR 670-1, commanders had to document their soldier’s tattoos in personnel files.  Although that has been discontinued, leadership will still have to check annually to ensure that enlisted personnel are not tattooed on their faces, necks or hands – ring tattoos are allowed – nor can tattoos be deemed extremist, sexist, racist or indecent.  Additionally, tattoos cannot be used against a non-commissioned officer seeking a commission or appointment.  All in all, these changes balance the need for quality men and women who are seeking a job in the U.S. Army but may have, or desire to get, a couple of tattoos.

Pinup girl Austin PicoSure Laser Tattoo Removal

While this relaxation of the U.S. Army’s rules on tattoos has decreased the potential for PicoSure laser tattoo removal somewhat, I can assure you that there are numerous other employers who do frown on tattoos.  Many companies, large and small, have a “no visible tattoos” policy.  Additionally, I see many patients who feel as though their ink is holding them back from that big promotion.  Although half of U.S. adults have at least one tattoo, this figure undoubtedly varies within certain demographics.  For example, do half of all college graduates running Fortune 500 companies have tattoos?  Answer: no, probably a very low percentage does.  If you find yourself employed by one of these companies or working for someone who doesn’t understand your reasons for getting tatted up, you can always let the PicoSure laser remove anything visible that’s holding YOU back.  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 is Documented Through Before & After Photographs

Someone once said that a picture is worth a thousand words.  Well that was Napoleon who coined the phrase but that’s another story.  So why do I take a picture of your tattoo before each PicoSure laser treatment?  Well, it’s because of what Napoleon said; it’s easier to just look at the side by side comparison shots then to talk about how much ink has come out.

One time I asked a patient how her fading had gone following her last treatment.  Her tattoo was on her wrist so she looked at it all the time.  It’s funny the way our brains work; when we look at something constantly we fail to notice subtle changes.  Our mind discards the previous image and stores the new one so we fail to see that anything’s taken place.  So back to the patient, she told me “I don’t think much came out.”  “Ok,” I said, “Let’s take a picture and do a before and after side by side.”  Wow, the difference was like night and day.  She was shocked.  And I was reminded how incredibly powerful the PicoSure laser is.  So there you go, a picture is worth a thousand words and it’s really fun to track the disappearing ink.  If you have a tattoo you want gone, 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 May Cause Temporary Ghost Images Following Successful Tattoo Removal

Occasionally I’ll get a question regarding a “ghost” image being left behind following PicoSure laser tattoo removal. The ghost image phenomenon is usually just transient hypopigmentation which generally resolves on its own in most cases – see example image below. So what causes hypopigmentation in the first place? During the course of treatments, the natural melanin pigment is removed via the same mechanism as the tattoo ink itself. Once the tattoo is gone, and the treatments are discontinued, the skin will repigment itself in time. However, one risk factor for permanent hypopigmentation is the number of treatments required to remove the tattoo; the fewer the treatments, the less chance for unwanted side effects. For this reason, I only utilize the PicoSure laser for all of my tattoo removal patients because it clears more ink in fewer sessions.

The PicoSure laser’s picosecond pulse creates a powerful PressureWave which shatters ink and allows it to be removed from the body. This is referred to as photomechanical impact and it’s a revolutionary technology that goes far beyond the simple photothermal action of old-style Q-switched lasers which can only heat up the tattoo pigment in an attempt to destroy it. In contrast to older Q-switched laser technology, the PicoSure laser actually decreases the risk of unwanted side effects such as permanent hypopigmentation and scarring. If you have a tattoo you would like 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.

Temporary ghost image:

Transient hypopigmentation

PicoSure Tattoo Removal Treatments are Scheduled 4-8 Weeks Apart

Occasionally I’ll get a patient who is up against a deadline for their tattoo removal.  For example, maybe they’ve got an upcoming wedding and their wedding dress would reveal some unwanted artwork.  Or perhaps, they would like to permanently remove that “old flame’s” name before the planned nuptials.  Perhaps they have a job interview with a company that doesn’t allow visible tattoos while on the job – think military.

Well this leads to an interesting discussion around how often we can treat a tattoo.  The standard answer is 4-8 weeks in between treatments.  However, if a tattoo has been previously treated and proven recalcitrant, I generally recommend 8 weeks between treatments to ensure the maximum amount of fading.  But, if a tattoo is small, it’s generally ok to treat it every 4 weeks.  Everyone else falls somewhere in between.  Some studies show that the longer we wait between treatments, the better the removal goes.  This is probably true with POS Q-switched lasers since they tend to damage the skin considerably which requires a lengthy healing time.  In contrast, when using the PicoSure laser, the skin is left intact and this shortens the time between treatments.  Additionally, since the skin itself cannot absorb the picosecond pulse, the majority of the energy is used to fracture and destroy the unwanted pigment.  Ultimately, this leads to better clearance and fewer treatments with PicoSure versus old-technology Q-switched lasers.

Calendar v2

Regardless, your tattoo removal regimen should be unique to you and customized based on your individual requirements, situation and ink.  A skilled PicoSure provider can discuss and tailor the various treatment strategies to optimize the tattoo removal whether you’re in a time crunch or not.  If you have a question regarding the speed of your removal, 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.

Holiday Tattoos are No Match For the PicoSure Laser

Happy St. Patrick’s Day week!  Did you know St. Patrick was the foremost patron saint of Ireland?  He died on March 17th which is the date the Irish celebrate St. Patrick’s Day.  According to legend, St. Patrick used the three-leaved clover, called a Shamrock, to explain the Holy Trinity to Irish pagans.  One popular variation of the Shamrock is the four-leaved clover which is supposed to bring good luck.  So what does this have to do with PicoSure laser tattoo removal?  It just so happens that probably more Shamrock and four-leaved clover tattoos are inked in March, especially this week, than any other time of year.  Turns out that it’s also one of the most regretted tattoos.  In fact, one of the original PicoSure clinical trial patients (see below) happened to have a four-leaved clover she wanted removed!  Before the advent of the PicoSure laser the green would have never come out.  I treat a lot of green tattoos successfully.  If you have a Shamrock or any other kind of clover you’re ready to get rid of give 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 Precise Treatment Regimens

Have you ever heard the old expression, “How do you eat an elephant?  One bite at a time.”  This quote is attributed to United States Army General Creighton W. Abrams, Jr.  So what does it mean?  Simply put “When you’re doing something big and difficult, do it slowly and be careful.”  The same can be said for large-scale laser tattoo removal with PicoSure.  I have a number of patients with huge tattoos that I’m removing and the results are truly incredible.  But there’s a reason for my success besides the fact that I’m using the world’s best tattoo removal laser; I do it slowly and carefully.  I like to describe the process as an “extremely thorough treatment”. Take a look at this example below of some “laser operator” who was not being deliberate and thorough.

BA B&A 2-10-15

This patient had undergone numerous treatments to his sleeve tattoo with a POS Q-switched laser which left him scarred and covered in residual ink.  His poor arm looked horrible and had for many years.  Take a look at what just 2 PicoSure treatments were able to accomplish!  It looks as though the area had never even been tattooed.  I carefully treated each stray mark and voila! No more tattoo.  Anyone might buy a laser but that doesn’t make them an experienced, dedicated tattoo removal expert.  Exceptional tattoo removal is a precise and exacting process.  It’s not like simply performing a photofacial or laser hair removal.  And as I have said before, both the patient and their provider must be committed.  Only then can a tattoo come off well; like it never even happened.  If you have a tattoo that’s been previously treated and you would like a second opinion, 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.

Can a Tattoo Removal Cream Replace PicoSure?

So maybe you’ve heard that a post-doctoral student named Alec Falkenham at Dalhousie University in Canada is trying to come up with yet another novel cream to fade away tattoos.  The cream is called Bisphosphonate Liposomal Tattoo Removal (BLTR) and it’s applied topically to the unwanted tattoo.  The university press release states that the cream will interfere with macrophages and allow the ink and the cells holding it to be broken down and absorbed by the body “over time”.  Actually, inhibiting white blood cells may be bad for us.  Additionally, how much cream would be required for the tattoo below?  How often would it be applied?

AR 9-14-13

Let me just say right now that I truly hope that this guy is successful but I seriously doubt he will succeed in replacing PicoSure laser tattoo removal.  Why?  Because the macrophage component is simply not enough of the story; it’s just a piece of it.  Once ink is trapped within the fibrous connective tissues of the dermis it is impossible for the body to remove.  That’s what gives tattoos their permanence.  However, could this cream, or something like it, be an adjunct to PicoSure laser tattoo removal in the future?  Very possible.  The reasoning may have something to do with healing times.  In some patients who heal their treated site very quickly, the ink is effectively “locked up” again just like when they first got the tattoo.  I’m not a research nurse anymore but at some point researchers might investigate how this Canadian’s macrophage inhibitor improves clearances when combined with the PicoSure laser by slowing down the healing process to a degree.

The overwhelming number of tattoos in the world can be removed with the PicoSure laser given the health of the patient, commitment to the treatment regimen and other factors.  If a tattoo can be cleanly removed in 3-4 PicoSure treatments over the course of several months then it’s probably preferable over a fade cream which might take years by itself and produce a less than aesthetically-pleasing result.  If and when someone does come up with a better way to remove tattoos I’ll gladly move on to another career but until then, if you have a tattoo you want off quickly and cleanly 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 Gets a New Handpiece to Target Resistant Reds

FDA grants 510k clearance for a new state of the art 532nm PicoSure handpiece for removal of resistant red, yellow & orange tattoo ink!  In fact, FDA approval actually came sooner than expected as the new handpiece demonstrated both safety and efficacy in removing unwanted red, yellow & orange tattoo inks.  Previously these colors had been difficult to remove due to their unique chemical formulations which have been known to include lightfast pigments as well as metals like titanium dioxide.  The 532nm wavelength is readily absorbed by red, yellow & orange tattoo inks making them highly susceptible to the PicoSure laser energy.  The example tattoo below was treated on the red and yellow inks only which showed a significant amount of clearance. I plan to be the 1st in the nation to upgrade my PicoSure with the new handpiece. If you have a colorful tattoo you would like to remove 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.

532 nm Handpiece532 nm Handpiece B&A

Microscopic Evaluation of Tattoo Ink Before & After PicoSure Treatment

Have you ever wondered just what untreated tattoos look like under a microscope?  Take a look at the photos below and you can clearly see the spheres of tattoo ink in human tissue samples on the left side.  In a large tattoo, there are literally millions of these pigmented “ink balls” located in and around billions of microscopic skin cells.  The spheres of pigment are trapped in fibrous connective tissue and unable to move which gives tattoos their permanence.  Even macrophages (white blood cells) which normally engulf and digest foreign substances like extracellular debris cannot remove these balls of ink.

Treated With PicoSure B&A

After the tattoo on the left side of our picture was treated with the PicoSure laser the balls of ink were fractured in to the smallest of particles by the patented PressureWave™.  Vaporized ink particles are now small enough to escape the fibrous mesh that was previously holding them stationary.  Some particles enter the clear fluid between cells and exit via the lymphatic system.  Any leftover ink is small enough that it can now be easily cleared by macrophages.  The image on the right shows the resulting ink clearance.  Each treatment clears more and more ink until the tattoo is no longer visible and the treatments can be halted.  If you have a tattoo you would like to have treated by my state of the art 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.


Tattoo Regret Can be Erased With the PicoSure Laser

Tattoo regret is a real phenomenon.  I can’t tell you how many people call me the day after they receive their tattoo.  Immediate remorse.  What’s interesting though is not that they regret getting a tattoo, rather they regret getting a bad tattoo.

I had one such patient call me today expressing horrible regret over the tattoo she received yesterday.  While we were discussing state of the art laser tattoo removal with PicoSure laser she texted me both the example picture she had provided the artist and the tattoo she had received.  Now I’m no art critic but wow, what a bad tattoo.  It didn’t look anything like the desired design – see below.

My advice is:  THINK BEFORE YOU INK! 

  • Even though it might cost more, go to a reputable artist with a proven track record. Make sure they haven’t cut and pasted their portfolio off the internet.
  • Carefully consider the size of your potential cover-up tattoo. They’re usually bigger than expected.
  • Give yourself time to imagine the tattoo on your skin. Consider that it will be there for life.
  • Location, location, location. Will this tattoo be seen by others at work? Can you wear a dress or shorts or a tee shirt without your ink showing?
  • What will your potential employer say? Do they have a policy banning visible tattoos? Many companies are moving that direction.
  • How will a future significant other feel about your ink if it’s someone else’s name or a tribute to another person?

My plainspoken advice is given from the point of view as an RN who provides PicoSure laser tattoo removal on a daily basis and has heard many different stories of regret.  Sometimes the patients feel as though they made a mistake even getting a single tattoo.  If you are having tattoo regret or simply would like to fade your design for a fresh new image, 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.

Hair Loss Following PicoSure Laser Tattoo Removal

I received a great question today regarding the risk of localized hair loss following laser tattoo removal with PicoSure.  The concern is a legitimate one but it has not been a problem in my personal experience.  I have only seen this in one patient and he had it prior to coming to me.

He had a sleeve tattoo on his right arm and underwent numerous POS q-switched laser treatments which left him scarred.  He had a lot of residual ink and his hair was thinner on that arm versus his untreated arm.  I was able to get out the residual ink in a couple of PicoSure treatments and we did not notice any further loss or thinning of hair.

A patient’s potential for hair loss would depend on several factors including the type of ink, location and design.  For example, if you have a distinct outline, we would only treat those lines which would spare any adjacent hair.  The PicoSure pulses so quickly that collateral damage is extremely minimal.  If you have a large shaded area, the settings are such that the ink would probably come out rather quickly.  The fewer treatments you have, the less likely it is that you could experience any noticeable hair loss or thinning. Hair color itself is also a factor with light colored hair being somewhat less susceptible to laser energy.

In summary, while hair loss or thinning of hair is a definite risk, in most cases it is highly unlikely that it would be noticeable or appreciable.  If you are concerned about the risk for hair loss following tattoo removal you can send me a pic or schedule a free consultation to discuss in more detail the treatment strategy to ensure hair loss is avoided or minimized.  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 Handpiece for Red Ink Tattoo Removal

The toughest tattoo colors for the PicoSure laser to remove have historically been various shades of red.  While the photomechanical PressureWave is able to break them up, the addition of more photothermal action may be required to remove some of the more resistant red inks.  For those patients with red remnants of ink the answer is the newest upgrade to the PicoSure laser which is a 532nm wavelength red-targeting handpiece. 

That’s right; the manufacturer (Cynosure) of the PicoSure laser has developed a new handpiece attachment that will emit a wavelength which is highly absorbed by red and orange ink creating a strong photothermal reaction.  When combined with the photomechanical action of the PressureWave, this additional PicoSure upgrade will give clinicians another tool to help those patients with resistant red ink.  The handpiece is currently before the FDA awaiting final approval – update:  Approved and working well! 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 – Performing Test Spots

Occasionally a test spot must be performed with the PicoSure laser prior to beginning treatments for tattoo removal.  There are several reasons why we might want to do a test spot.  Firstly, if a light colored ink is suspected to have a high titanium metal content then it might be good to test it first in order to ensure that it doesn’t turn grey or darker.  Luckily, this phenomenon is quite rare; however, if the test spot becomes dark or the ink color changes then a conversation regarding strategy must take place.  If it is determined that the ink will not come out then the patient must be given other choices to consider such as a cover up, excision or pigment camouflage.  Additionally, a test spot is sometimes required when a patient wants to see how their particular ink will respond and whether or not they believe they can withstand the treatment regimen.  I always comply with a test spot request, at no charge, just to ensure both myself and the patient agree that there’s a high probability that their outcome will be successful.

For benign pigmented lesion removal on the face (melasma, freckles), a test spot is also recommended and always a good idea to prove that the whole area will clear as desired.  In other words, when in doubt, request a test spot be performed.  Your final decision can be based upon the results and you will feel more confident going in.  If you live in the Austin area and would like a test spot on your 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.

How Thorough is Your PicoSure Treatment?

I’ve had a couple experiences where patients relocate out of state halfway through the PicoSure tattoo removal process.  On two different occasions I’ve had those same patients call me up from their doctor’s office and ask me to explain to their new PicoSure provider how I was removing their tattoos because nothing seemed to be happening now.  It seemed impossible that if they were using a PicoSure instrument that they weren’t getting the same results as they did here in Austin.  How can this be?

It’s important to remember that a laser, even one as powerful and complex as the PicoSure, is simply a tool.  In many ways it’s no different than a scalpel or any other piece of medical equipment.  The results depend on the training, experience and completeness of the treatments provided by the user.  While there are a number of adjustments that can be made to the PicoSure laser’s settings, the technique is just as important.  I’ve had many patients tell me “you take so much more time treating my tattoo than my last (provider)”.  Think about it, if your tattoo is 6×6 inches and the laser spot size is 2-3mm in diameter, it will take some time to ensure that I’ve covered every square millimeter of ink.  Why is this important?  Because the more thorough and precise I am, the fewer treatments you will need to fade or remove your tattoo.  Ultimately, this means your tattoo comes off faster and you spend less money to do it.  Additionally, fewer treatments lessens the risk of unwanted side effects.  Beware of a provider who says they’ll treat you forever until your tattoo is gone.  It doesn’t have to take forever if you’re using the right laser and applying it correctly.

Committed to Your PicoSure Tattoo Removal?

Unfortunately, even the PicoSure Laser takes time to completely remove a tattoo.  Numerous treatments may be required, over many months, to achieve optimum clearance of certain inks.  Why?  Because some inks are very tough, deeply hued, or both.  Many inks are tweaked by manufacturers to improve their “lightfastness”.  Lightfastness is the degree to which a pigment is permanent or is unaffected by exposure to light.  Some of the same pigments used in tattoo inks are also used in paints and dyes.  If you pick up a can of paint you can see a lightfastness rating printed right on the label.  Furthermore, pigments must also be chemically and physically stable which is why manufacturers add a number of secret proprietary ingredients to ensure that their inks are tough and durable.  Often these ingredients can include various metals such as titanium, chromium and iron.  Some metals are highly lustrous and have the ability to reflect even laser light or they can change form and coloration during the tattoo removal process.

An experienced PicoSure provider should be able to advise you on how your particular ink is responding and what strategies may be incorporated for optimum clearance.  If you want to discuss your options 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.

Tattoo Ink Darkening in Response to Laser Treatment

Why don’t some tattoos respond to laser treatment?  Unfortunately, not even the best laser on the planet, the PicoSure, can remove all tattoos.  The primary reason for this is that the ink, or one of its components, usually a metal or metal derivative, responds negatively or not at all.  For example, white inks contain large amounts of titanium dioxide which is a highly reflective white metal oxide.  Titanium dioxide has an extremely high refractive index which is why it is used in the majority of sunscreens.  Additionally, because of its pure white coloration, titanium dioxide is also used as an additive in many cosmetic and food pigments.  Regrettably, when a tattoo pigment of titanium dioxide is struck with a laser beam it may cause laser-induced reduction of the metallic compounds resulting in a permanent darkening of the ink.  And it’s not just white ink that’s affected because white titanium pigment is added to numerous colors in order to lighten them or increase their brilliance.  In other words, almost any pigment has the potential to turn darker when treated with any laser, including the PicoSure laser. Interestingly, other metals have also been found in tattoo inks, including mercury, iron oxide and chromium.  In summary, not all tattoos can be removed with laser treatment and those that can may require numerous treatments due to the resilience of some inks, especially those containing metals.


Please call Brendan @  512-327-5337

Tattoos Can Be Lifesavers!

Did you know that some tattoos can help save a life?  According to, over 230,000 new cases of breast cancer will be diagnosed in 2015.  There are a variety of treatments that oncologists use to treat breast cancer in its various stages.  One treatment in particular, radiation therapy, uses small target tattoos to assist radiation therapists to accurately aim the instrument which irradiates the tumor area.  Patients may require up to 5 of these tattoos depending upon their condition.  The radiation treatment is similar to getting an x-ray but much more intense.  Patients may undergo numerous treatments over a number of weeks.  With each treatment, the target tattoos, which are about 1mm in diameter, help ensure the accuracy of the treatment.    While some women see these small black dots as marks of survival, others would rather have them removed because they can be a painful reminder of a difficult time.  Once a woman is given an all clear by her oncologist, these tattoos can be easily removed with the PicoSure laser.  I perform these treatments free as a service to the resilient women who have persevered and survived breast cancer.


Please call Brendan @  512-327-5337

PicoSure Laser Treatment – Blisters & Caring for the Treated Area

Blistering is a common side effect of PicoSure laser treatment but it is not indicative of whether a treatment will be more successful.  These blisters are generally not thermal in nature but rather, they are produced by the photomechanical action of the PressureWave.   Several factors may increase the likelihood of blistering including the size, color and location of the tattoo.  I have performed thousands of PicoSure treatments and found that while blistering is common it is also harmless.  Some patients blister very little or not at all and still have outstanding clinical results.  When blistering is severe it can be unnerving to a patient who experiences this phenomenon for the first time.  Large blisters can be drained and the entire area should be kept clean, moisturized (I recommend Aquaphor) and covered.  Blistering usually subsides in about a week and can be followed by redness which can last up to 8 weeks.  It’s important to remember that these signs and symptoms are normal responses to treatment with PicoSure.


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


The new PicoSure Laser tattoo removal system is better at removing blue ink because it uses photo-mechanical principles as opposed to relying on photo-thermal action alone. Older POS Q-switched lasers simply heat up the target area to break up the tattoo ink but picosecond technology takes advantage of photo-mechanical impact/stress to shatter ink into the smallest of particles. This results in lower energy requirements for removal, less collateral damage, better clearance and fewer treatments.

Due to the fact that I am extremely meticulous and thorough when applying the PicoSure laser, you may very well see dramatic results after the first treatment. The variables include the type of ink used, size and depth of the tattoo as well as skin type. I should be able to give you some indication during the consult based upon my experience clearing many tattoos of varying types.

There’s no need to wait until after summer to begin treatments. The treated area should be covered by clothing in the sun but if this is not practical a sun block of SPF 30+ may be applied. Avoid the use of spray tan or natural tanning two weeks prior to each treatment.  If you have a black, blue or other colorful tattoo that you want gone I can be reached in Austin, TX  at my new location inside Austin Medspa @ 512-479-9997.

Recalcitrant Blue Ink Before & After 1 Treatment - Hall Plastic Surgery & Rejuvenation Center

PicoSure Tattoo Removal Before & After Photos

Click to enlarge.

Selective removal of just the butterfly.  PicoSure with Boost and 532nm handpiece were used.

Butterfly Tattoo 532nm Austin PicoSure Laser Tattoo Removal

Multicolored butterfly.

Butterfly Austin PicoSure Laser Tattoo Removal

Large back piece that covered the left shoulder blade.

Skull Before & After Side by Side FINAL

Before and after of backpiece fade for cover up tattoo placement.  Gorgeous!

HPS Before & After 5-13-14

Same piece used in a PicoSure ad.

PicoSure Fade Ad 7-14

Large black tattoo with grey shading.

BL Ghost B&A 4 PicoSure Treatments

Purple & black wrist tattoo which would have been difficult to remove without PicoSure.

AD B&A v2

Black & red longhorn.

BL B&A 2-11-14

Selective removal of only the wording.  The loss of tan is temporary.

VS B&A v2

Medical symbol.

BL B&A v2 2-11-14

Recalcitrant blue/green tattoo remnant which had been treated numerous times with q-switched lasers.

DK B&A 2-2-15

Multicolored ankle tattoo before & after PicoSure treatment.  Residual red will be treated with new 532nm handpiece.

Recalcitrant partial sleeve tattoo that had been treated numerous times with a POS q-switched laser.

BA B&A 2-10-15

Microscopic cross-section of human tissue before & after PicoSure treatment.

Treated With PicoSure B&A

Permanent eyebrow tattoo before and after PicoSure.

Eyebrow - Austin PicoSure Laser Tattoo Removal Hall Plastic Surgery


If you need a tattoo faded for cover up artwork or removed altogether give Brendan a call for a free consult and quote. 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.