Video Archives

PicoSure Laser Tattoo Removal Of A Cover-Up

I see many homemade tattoos that patients received as students in high school. These tattoos generally use poor quality ink and are often put in with dull needles and lousy techniques that frequently cause scarring. Scarred skin tends to reveal itself after the ink is removed. It can also hold onto ink harder than healthy tissue. In the case study below, the patient had a homemade cross tattooed on her shoulder blade. Sometime later she had a cover up of a kitty put on by a professional. When she came to me to have PicoSure laser tattoo removal she asked if it mattered that there was another tattoo underneath. I explained that it did not; however, multiple layers of ink can affect the number of treatments required. If you look at her series of photographs during the removal process, you see how the cover up came off first which revealed the original cross design beneath. Once the cross was also removed, scarring from the crude tattooing process could also be seen.

Kitty Austin PicoSure Laser Tattoo Removal

While teenagers will never stop getting tattoos, we must encourage them that if they are going to do it anyway they should do it safely and in a professional shop with sterile needles and talented artists. If you have a crude tattoo from high school that you want cleared quickly and effectively using PicoSure laser tattoo 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.

PicoSure Laser Tattoo Removal With New 532nm Handpiece – 1st In Texas!

Success!  Today I was the first nurse in the entire Southwest to use the new PicoSure 532nm handpiece for red, yellow & orange tattoo inks!  I was very impressed with the reaction created by the treatment.  Both yellow and red ink “frosted” in response to the 532nm green laser beam.  You will recall that red (and its variants) appear red because they absorb green light and reflect red light.  The appearance of the 4 red & yellow tattoos I treated today indicated that the ink was sufficiently destroyed by the laser energy and resultant PressureWave.  I fully expect a great deal of ink clearance over the next 6-8 weeks.  What makes this 532nm handpiece unique is that it too pulses in the picosecond range.  Picosecond pulse widths ensure maximum clearance and minimal or none unwanted side effects.

532nm Photo Austin PicoSure Laser Tattoo Removal

Due to the popularity of red, yellow, orange & pink inks in modern tattoos, I have a number of patients who were waiting specifically for this new handpiece.  I worked closely with CynoSure, the manufacturer of the PicoSure laser, to ensure I would be the first in Texas to get it.  Turns out, I’m one of the 1st in the entire world!  When you combine this fact with the fact that I received one of the initial PicoSure units ever produced (April 2013), it means that I have a great deal of experience and have worked tirelessly to bring my patients the finest tattoo removal treatment available.  If you have a resistant red, yellow, orange or other colorful tattoo you would like removed with a fully up-to-date and state-of-the-art 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.

Tattooing Robots Might Decrease The Need For PicoSure Laser Tattoo Removal

Could your next tat be applied by a robot?  Answer: Yes!  A company called Appropriate Audiences has developed a robotic tattoo machine that inks a tattoo in a manner similar to printing.  Although the device is still being tweaked and developed, chances are it will be available everywhere before you know it due to rapid advances made in prototyping and technology in general.  Think local shopping mall tattoo kiosk.

Robot Austin PicoSure Laser Tattoo Removal
Robotic Tattooing Video

In my work as an RN, performing PicoSure Laser Tattoo Removal, I see some horrendous (ugly) tattoos.  Many of these are inked by less-than-talented “artists”.  Rule #1: Always use a reputable, talented and experienced tattoo artist.  Although it might cost you a little more, you will be much happier with the final result and far less likely to experience tattoo regret.  However, with robotics, the design is applied just like printing a photo so what you tell the robot to do it does without variation.  This is important because every day I hear stories of how a customer goes in with a design in mind, even provides a picture, and comes away with something nowhere close to their original intent.

Although the current robot uses an actual needle, future tattooing robots could utilize lasers.  The customer might simply place an inked decal onto the desired location and the laser would pulse over the design, releasing the ink and making a microscopic hole in the skin at the same time.  The result would be exactly what the customer ordered.  Strange thought right? putting them on with one laser and taking them off with a different laser.

Hundreds of years ago, book manuscripts were handwritten by talented caligraphers who were all subsequently replaced by the invention of offset printing presses.  Not so long ago, professional artists working for advertisers got replaced by graphic artists using Adobe and Photoshop.  Here we go again, this time with tattooing.  However, in the meantime, if you have a tattoo that was applied by a not-so-talented human and you would like it 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.

Homemade Tattoos Cannot Withstand the Removal Power of the PicoSure Laser

You may have noticed numerous tattoos over the years that were obviously homemade and wondered what the artist or their client was thinking at the time.  Luckily, these unprofessional tattoos cannot stand up to the PicoSure laser when it comes time for laser tattoo removal.  Many of these inks, though not professionally made, can be quite tough because of the ingredients used.  For example, in the tattoo image below, my patient had used burnt blue razor handles mixed with water to make the ink.  I imagined these dots would come right out but the removal was actually much tougher than it first appeared.  Plastic soot is quite difficult for the body to remove.

Homemade Tattoo Austin PicoSure Laser Tattoo Removal
Homemade Tattoo Using Burnt Plastic For Ink

Fortunately, the PicoSure laser pulses so quickly (think trillionths of a second) that the ink is shattered into the smallest of particles by the resultant PressureWave.  Residual ink particulate matter can then be easily carried away by the body’s lymph system or scavenged and removed by macrophage white blood cells.  When combined with the Boost upgrade, virtually no particulate, plastic, metal or other strange ink, can withstand the laser’s energy and the state-of-the-art way in which it is delivered.  If you have a homemade tattoo that was laid in with India ink, burnt plastic spoons, razor handles or whatever, and you would like it 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.

PicoSure Laser Tattoo Removal Treatment Intervals Must be Strategically Adjusted

Once a patient has made the decision to have their tattoo removed with the PicoSure laser it can almost become an urgent situation.  I have multiple patients who want their treatments spaced apart as closely as possible to ensure that the removal is as fast as possible.  Rather than waiting 6-8 weeks between treatments they request every 4 weeks which is the shortest possible treatment regimen.  While this is fine for small tattoos in patients who heal quickly, it is not advisable for large tattoos or for those with an ink that demonstrates resistant characteristics.  Why?  Well to begin with, large tattoo treatment areas require more time to heal.  Additionally, the more ink there is to be absorbed the longer it will take to do so.  In fact, some studies paradoxically indicate that the more time there is between treatments the faster the overall removal is completed!

Hourglass Austin PicoSure Laser Tattoo Removal

To be honest, there are “tattoo removal clinics” that will treat your tattoo every 4 weeks indefinitely, regardless of how you’re doing with clearance or healing times.  At my office, which is located within a state-of-the-art plastic surgery center, we follow the patient closely and monitor the treatment area for the slightest changes.  Based upon this information, we can adjust the treatment regimen accordingly to optimize both healing and ink clearance.  After all, we want a fantastic result not just a scarred up ink removal.  Every patient is different and each removal strategy is individually tailored based on a variety of factors.  If you have a tattoo you want 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.

Let the PicoSure Laser Erase Your New-Onset Tattoo Regret

Can you imagine waking up the day after you got your new tattoo and already having tattoo regret?  Or how about the very first time you saw your new ink in the mirror and experiencing regret before even leaving the tattoo shop?  It’s a lot more common than you might think.  Every day I hear stories like “It’s not what I wanted.” or “It’s a lot bigger than I thought it would be.”  When this happens, a patient still must wait 4 weeks before beginning removal treatments to ensure the skin is completely healed and ready to accept the laser energy.

Let’s face it, sometimes a tattoo just doesn’t turn out right and the victim is forced to seek out a state-of-the-art removal remedy such as the PicoSure laser.  I treat tattoos every day with PicoSure and I never cease to be amazed at how effective it is – even on previously treated tattoos.  I had one such patient today.  She’s got a big tattoo on her lower back which was treated a dozen times with a q-switched laser.  The treatments left her scarred and with a ton of ink still under her skin.  In fact from a distance, her tattoo looked like it had never even been treated.  That’s a tough situation; pay for 12 treatments and nothing happens – wow!

Anyway, I saw her again today and in a single treatment with PicoSure the before and after pictures revealed a delightful surprise: much less ink!  If you have a tattoo you want 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.


PicoSure Lasers Free Trapped Tattoo Pigments

Have you ever wondered what gives tattoos their permanence?  There are several factors that account for why tattoos essentially last a lifetime.  Firstly, the pigments are not water-soluble which means your body cannot dissolve them.  We can think of tattoo ink as microscopic multicolored balls made of clay, metal, minerals or any number of combinations thereof. Individually they’re essentially invisible but when layered throughout the skin by the millions of particles we can see their color in the form of a tattoo.  Once the skin heals from the initial tattooing process, the balls of ink are trapped within and around fibrous cells and collagen fiber mesh.  The colorful particles cannot move or escape, much like glass floats tied into the web of a fishnet.  However, just like the glass balls in a fishnet, if the tattoo ink is shattered it can easily pass through the web of tissue that’s holding it in place.  The PicoSure laser is the most effective method for shattering tattoo pigment in to the smallest of particles by creating and utilizing a powerful PressureWave.  It is more effective than the best Q-switched lasers and safer as well because its pulse lasts just trillionths of a second and will not burn the skin.  If you have a tattoo you want 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.

Tattoo pigments, like Glass floats, are trapped in a fibrous web.


Size Doesn’t Matter With PicoSure Laser Tattoo Removal

You may be reading this right now and dreaming of finally removing that tattoo you can’t stand anymore.  Perhaps you would like a cover up but your artist has told you that your choices are limited due to the size and color of your current ink?  Well the PicoSure laser can fix all that by fading away unwanted ink quickly.  Look at this example below which my patient has graciously allowed me to show you for demonstration purposes.  This gentleman is into tattoos but was tired of his old ink.  In this progression of photos we see the transformation.  All three of his original back tattoos were treated at the same time every 6-8 weeks for a total of 3 treatments.  The photo second from the left was during the period when he was still absorbing ink so his final fade was even much lighter.  In fact his artist told him that it was like working with a blank canvas.  This patient traveled all the way to Japan for his new design, which is still in process.  I will publish an updated photo upon completion.  If you want a cost-effective and thorough fade of your tired artwork or are considering total 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.

AR B&A 3-26-15

Black Tattoos May “Appear” Resistant to PicoSure Laser

How black is black?  Sometimes a very deep dark black tattoo initially appears as though it’s resistant to PicoSure laser tattoo removal.  However, we know what’s taking place on a microscopic level; ink particles are being shattered by the photomechanical PressureWave and carried off by the body.  So why does it look as though nothing is happening?  Well we have to go back to my original question regarding just how black are some blacks.


When we remove a layer of black ink we reveal the layers below which are also black.  Because the skin is translucent, meaning we can clearly see through it, the remaining layers of black ink are still extremely visible.  It’s sort of like an old printer running out of black toner; the words get lighter and lighter but we can still read them quite clearly.  It may take 4 or 5 treatments before we see islands of clear skin within the blackest of tattoos.  So what does all this mean to a PicoSure tattoo removal patient?  We have to be patient on some tattoos and trust in the technology.  Hopefully your provider is charging you a fair price and even though you may require a significant number of treatments to remove your coal-black tattoo it will still be affordable.  Remain committed to your tattoo removal and you will be glad you did.  If you have a dark black tattoo that is heavily saturated with ink and you would like it safely and thoroughly 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 Improves the Appearance of Scars

Sometimes I see the scars that directly result from the tattooing process.  The longer a tattoo takes to put on the duller the needles become.  Dull needles not only make the tattoo placement more painful but they increase the risk of scar formation.  Why?  Because needles are just like tiny scalpels and the cuts they make can be quite visible.  Initially the cuts are very fine because the needle is sharp but after just a few minutes the needles start to become dull.  Under a microscope we can see that just a few pinpricks can make a needle jagged.

Click here to see the needle images:


Eventually the needle is tearing the skin as opposed to simply penetrating it.  All of those tiny tears must be repaired by the body and sometimes the result is scar tissue.  Scar formation may be exacerbated by the introduction of a volatile ink that causes an allergic response.  “Homemade” tattoo artists have been known to reuse needles.  The needles become more and more dull with each use and increase the risks for scarring. The good news for tattoo removal patients is that the PicoSure laser is FDA cleared to improve the appearance of scars.  I have a number of scarred patients who experience flattening out and softening of their scar tissue during the PicoSure laser tattoo removal process.  So not only does the risk of scarring go down by using the PicoSure for tattoo removal versus some POS q-switched laser but any existing scars can be significantly improved.  If you have a scarred tattoo you would like for me to evaluate at no cost, 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 Treatments Don’t Have to be Painful

If you’ve ever wondered what “air-cooling” for comfort means it’s the use of a chiller to cool the skin and diminish the pain associated with PicoSure laser tattoo removal.  If you recall, the laser energy passes painlessly through most skin types and concentrates its energy on the pigment.  However, the reaction with the pigment can be strong and produce pinpoint bleeding, frosting and bruising of the treatment area.  When this occurs, the nerve endings send a signal to the brain that something is happening.  The pain has been likened to a rubber band snapping against the skin.  This is an accurate statement due to the fact that the patented PressureWave does cause a strong photomechanical impact.  The tattoo pigments are shattered in to fine particles as a result of the impact stress which allows them to be removed by the body.

All in all, the PicoSure laser tattoo removal treatments are much faster than the tattooing process itself and are rarely excruciatingly uncomfortable.  In addition to the air chiller (shown below) I also may use topical numbing cream, when necessary, and take appropriate breaks to allow the patients to relax.  Some folks like to wear their headphones to block the sound of the laser while listening to their favorite tunes.  Whatever it takes, we’ll do it.  Before you know it the treatment is over and you’re one step closer to having that tattoo gone forever.  If you would like to discuss your tattoo 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.


PicoSure Lasers Can Remove Black, Blue, & Green Inks Better

So what’s the deal with BLACK ink?  You may have heard that it’s the easiest color to remove.  In many respects that can be a true statement if you’re using a POS q-switched laser and don’t have access to a PicoSure instrument.  Why?  Well because q-switched lasers have a difficult, if not impossible, time trying to remove blue, green, purple and recalcitrant inks.  So they focus on black which produces the strongest photothermal reaction.  Q-switched lasers fire so slowly (nanoseconds) that black ink is able to absorb all of the energy and heat up to temperatures capable of burning the tissue and leaving a scar.  Consequently, these old-style lasers like to focus on black ink and the operators correctly state that for their particular laser “black is the easiest color to remove.”

But there’s another reason; POS q-switched lasers can’t produce the patented PicoSure PressureWave™ which breaks down all ink colors, including blue, green, purple and recalcitrant blacks.  Before the advent of the PicoSure, photothermal reactions (superheating the ink) were the only way that a tattoo would come off.  But this routinely left the patient scarred and hypopigmented.  Researchers knew that a PressureWave™ would solve this problem and they worked tirelessly to invent a portable laser capable of firing a pulse measured in the trillionths of seconds and at least 100 times faster than conventional q-switched lasers.  The result was the PicoSure that removes all the tough colors, including black (a red handpiece is coming soon).  In head to head clinical trials, the PicoSure significantly outperformed q-switched lasers on black ink.  So, that’s the deal with BLACK ink.  If you have a tattoo you would like to remove that’s black or multicolored, 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.  You’ll be happy that you did.

PicoSure Laser Tattoo Removal Case Study

Do you believe in miracles?  Well for some patients the PicoSure laser represents just that; a miracle of modern medicine.  For this featured case study patient his journey has been a long one.  He started laser tattoo removal 10 years ago for a partial sleeve on his right arm.  Back then all that was available was a q-switched laser incapable of real efficacy.  His numerous treatments left him significantly scarred and there was a ton of residual pigment.  Additionally, the hair on his treated arm had fallen out and become much thinner.  His arm is shaved in these photos to facilitate PicoSure treatment.  Eventually the hair on his arm did return.

You can see this gentleman’s  “before & after” pictures below.  In just 2 treatments, the PicoSure laser was able to effectively remove his residual ink and flatten out his scarring to the point where it is far less noticeable and his skin is much more supple.  Point of fact, the PicoSure laser was just additionally cleared by the FDA to treat scars because of its ability to cause scarring to remodel in to more aesthetically pleasing tissue.

BA B&A 2-10-15

This patient is extremely happy with his PicoSure results and allowed me to document the removal for your benefit here.  If you have a seemingly impossible tattoo 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.

Professional Dress Code – Can Tattoos Hold Us Back in Business?

More and more I hear that patients are removing tattoos for work.  In some instances this is mandated by their employer.  For example a corporation might adopt a “no visible tattoos” policy.  Starbucks had banned all visible tattoos but lifted its ban last year as long as the tattoo was “inoffensive” and not located on the face or neck.  This policy change was as much about not alienating a significant chunk of the labor market as it was about inclusiveness with respect to customers.  However, many corporations have implicit rules against tattoos of any kind.  The San Antonio and Austin police departments ban visible tattoos but allow long sleeve shirts to cover them up – that can be tough in the Texas summer.  Tattoos on the neck must be surgically or medically removed.  I’ve even used the revolutionary PicoSure laser to remove tattoos on patients who were seeking a career in the U.S. military.  (First responders like the police or military always get a professional discount because of their service to our communities and country.)


Employer Austin PicoSure Laser Tattoo Removal

Patients may feel that their body art makes them appear less professional in certain professions.  I have a variety of professionals who want their ink off because of work related matters.  If we’re to be honest, image means a great deal in business and certain circles.  To remove a tattoo for business purposes is a personal decision but one that might make all the difference in getting ahead or moving in to a career that brings fulfillment and advancement.  If your ink is holding you back, please give me a call and let me help you move onto the next phase in your profession.  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.

Removing Tattoos is a Physical Process Not a Chemical Process

Why is it that there are no magic creams to fade away tattoos?  Why do products that purport to remove tattoos using a special brush and a proprietary ointment (think wrecking balm) not work?  And if they did work, would laser companies still build medical lasers which cost hundreds of thousands of dollars?  If we could wipe away our mistakes with snake oil I would gladly close up shop and send the revolutionary PicoSure laser back to its manufacturer.  The world would have a lot less tattoos if a $50 cream in a fancy box could remove a tattoo.  Millions of people want to erase their mistakes but I’m here to tell you that it takes dedication on the part of the patient and their provider as well as the right tool; a PicoSure laser.

But back to the original question of why don’t topical creams or ointments work?  Well it’s because there is no known chemical reaction that can break up tattoo ink once it is set in skin.  For example, if we used an acid powerful enough to destroy tattoo ink, what do you think its effect on the skin would be?  The skin and the ink it holds would be destroyed leaving a terrible chemical acid burn in its wake.

The key to removing tattoos is not chemical it is mechanical.  As the PicoSure laser fires into the skin it produces two effects.  First it heats the pigment which is known as a photothermal reaction.  Secondly, it produces a photomechanical PressureWave™ which shatters ink into the smallest of particles.  Neither of these actions are chemical reactions.  The ink is not chemically dissolved; it is physically vaporized and then absorbed and removed by the body.  In summary, there is no magic chemical which can dissolve ink in the skin without harming the skin itself.  Removing tattoos is a physical process involving heat and pressure.  Want to talk about it?  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 Before & After Photos Case Study

Let’s look at an example of a patient who I recently treated with the PicoSure laser.  This particular tattoo was black in color and located on the upper left shoulder blade.  The tattoo had been professionally inked and utilized a high quality pigment that had maintained its lightfastness despite the fact that this patient snorkeled regularly and enjoyed working outdoors.  The tattoo was approximately 15 years old and was put on while this young man was serving in the U.S. military.  The patient had decided to remove it because he had grown tired of the design.  It took a total of 4 treatments to achieve complete removal.  I use this example due to the tattoo’s size.  I frequently treat large tattoos and the success rate is the same as with any other tattoo.  However, regardless of the tattoo type, color, location or age, a commitment is required on the part of the patient and their provider to successfully clear unwanted ink.  If you want to talk about it 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.

Skull Before & After Side by Side FINAL

Volatile Pigments and the PicoSure Tattoo Removal Process

I’ve been asked several times if removing a tattoo with the PicoSure laser can release any dangerous chemicals into the body.  While many tattoo inks vary widely in their chemical makeup, the vast majority are inert and usually harmless.  Generally speaking, if a patient was going to have a reaction to a particular ink, or one of its ingredients, it would most likely happen immediately following the tattooing process.  Allergic reactions can include redness, raised areas, rash and even scarring.  However, once a tattoo heals the ink is bound in the dermis, by cells called fibroblasts, where it remains until shattered by the PicoSure laser.  Some ink particles are immediately vaporized, while others are carried away by phagocytes.

Interestingly, I have had several patients state that they can “taste” the ink in their mouth during the procedure.  This is most likely caused by harmless microscopic gas bubbles entering the circulatory system and imparting the “taste” through some unknown mechanism.  Again, this phenomenon is harmless.  At this point, hundreds of thousands, if not millions, of laser tattoo removal treatments have been performed successfully and the FDA continues to approve new and more powerful lasers for this purpose.

When performed correctly, the risks associated with PicoSure laser tattoo removal are generally minimal and the results can be quite amazing.  However, we must also recognize that all medical procedures have the potential for harm and ultimately the decision to remove a tattoo rests with a patient and their physician.  For example, in the surgery center where I operate the PicoSure, our Medical Director does not allow tattoo removal treatment on women who are pregnant.  If one of my patients becomes pregnant we postpone further treatment until after delivery.

Pain Associated With PicoSure Tattoo Removal

I was treating a tattoo with PicoSure today that wrapped entirely around the patient’s right lower leg mid-calf.  She’s having her existing tattoo faded in order to place a full lower leg piece.  This was her first PicoSure treatment and she asked if it would hurt worse when I passed over the thinner skin in front of her bone.  The truth is that pain is different for everyone.  After the treatment she said it felt the same all the way around.  I use a continuous cool spray of air throughout the treatment and all patients report that this is extremely helpful.

I do know from experience though that some parts of the body are more sensitive than others – especially if they’re heavily inked.  This afternoon I was performing a treatment on a patient’s rib cage and she requested numbing cream due to the sensitivity of that particular area.  Taking frequent breaks allows the patient to catch their breath and relax.  Squeeze balls (stress balls) also help.

I do whatever it takes to make the PicoSure treatments as comfortable as possible.  However, one thing I won’t do is rush through a treatment just because it’s uncomfortable.  Practitioners who speed through a treatment just to “get it over with” are doing a disservice to their patients because they’ll just wind up needing more treatments in the long run.  Want to remove 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.

R-20 Method Explained

We sometimes hear the term “R-20 Method” in laser tattoo removal.  R-20 refers to the practice of “repeating” the laser tattoo removal procedure after 20 minutes.  The technique was developed by a physician who wanted to clear tattoos more rapidly.  However, the study pointed out that although it appeared to be initially helpful in some black inks, colors like green and blue were resistant.  Additionally, it has been shown that the more laser energy put into a given area increases the risk of tissue damage and thermal injury.

The R-20 process:  When a tattoo is treated with a laser, the area “frosts” or looks cloudy.  This frosting is caused by gasses forming under the skin.  Doctors who perform the R-20 method must wait 20 minutes for these gasses to reabsorb before doing the next pass with the laser because the gas layer effectively blocks or reflects the laser energy.  Some practitioners repeat the tattoo removal treatment every 20 minutes for a total of 4 passes.  Even some PicoSure clinics have utilized the R-20 method.  I have seen patients who received scarring resulting from both Q-switched and PicoSure R-20 procedures.

I personally do not use the R-20 method because I don’t believe it is necessary when the PicoSure settings are correct for a given tattoo and the delivery is meticulous and methodical.  In short, a single pass, performed correctly, can be just as effective as 4 quick passes.  In fact a thorough single pass may actually improve the outcome because it requires precision and technique while reducing the energy put into the tattoo and surrounding skin.  And let’s not forget, a single pass is less expensive than charging a patient 4 times the standard treatment amount.  It is also less damaging to the skin and takes less time.  The clinical trials which were used to get FDA clearance for the PicoSure did not use R-20 as a treatment standard.

In truth, technique is a huge part of the effectiveness of the PicoSure laser.  A laser is a tool just like any other.  We know that buying a cook book doesn’t make us a chef.  Handing a scalpel to an intern doesn’t make them a brain surgeon.  Tattoo removal with PicoSure requires strategy, experience and commitment on the part of the practitioner and the patient.

Please call Brendan @  512-327-5337

Scarring & Tattoo Removal


Occasionally a person will receive a tattoo and their skin is permanently damaged.   The tattooing process itself may cause scarring, raised areas, redness or other adverse reactions.  This may be due to an allergic reaction to a particular ink or one of its ingredients.  Visible scars may also be the result of the micro-scarring effects of the thousands of needle punctures required to place large tattoos.

Patients contemplating tattoo removal may worry that once the tattoo is gone a scar or hypopigmentation will be visible.  However, anecdotal evidence suggests that PicoSure™ treatments may soften these scars and perhaps flatten them out, which can improve their appearance.  If you are concerned about post-removal hypo-pigmentation, you may want to see a PicoSure™ provider.  This is because a PicoSure™ laser often requires fewer treatments which lessens the risk of side effects.  But if you do experience permanent hypo-pigmentation, a skilled esthetician may be able to improve the appearance significantly by using a permanent pigment that matches your own skin.  These pigments are applied just like a tattoo and have been used for years to disguise scars, marks and unwanted blemishes.


Please call Brendan @  512-327-5337

Laser Tattoo Removal – Austin PicoSure

Hello again,

Since I utilize the PicoSure Laser for tattoo removals, I thought it fitting that I post a video showing just what makes this laser so unique.  Enjoy!

Questions or comments?  Post them below and I’ll get right back to you.  Thanks!


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

Actual Treatment with PicoSure Laser – Selective Tattoo Removal

If you’ve ever wondered how a treatment is performed, you can watch me removing a tattoo from Val Santos, one of our local radio celebrities here in Austin.  This was a selective removal; meaning she only wanted part of the tattoo gone.  In the end, the unwanted portion of Val’s tattoo was completely erased.  Her beautiful tan should return this summer.  Thanks for the experience Val!     –