“The big misconception with tattoo removal is that it’s an eraser,” Sherrif F. Ibrahim, M.D.,, an associate professor in the department of dermatology at the University of Rochester, tells SELF. But it’s not that simple. “It’s a process,” he says. Sometimes, complete removal of a tattoo can take one or two years, with treatments occurring every 6, 8, or 12 weeks. Plus, it’s not like getting your eyebrows waxed—it’s an invasive procedure that costs hundreds of dollars a session. Lasers remove tattoos by blowing up pigment molecules into tiny pieces, which are then cleared away by an immune system response. Healing from laser treatment isn’t always a walk in the park, either. “The laser breaks the skin’s surface, so you have bleeding, you have swelling, and you have pain after the treatment,” says Dr. Ibrahim.
Tattoos are meant to be permanent. Artists create tattoos by using an electrically powered machine that moves a needle up and down to inject ink into the skin, penetrating the epidermis, or outer layer, and depositing a drop of ink into the dermis, the second layer of skin. The cells of the dermis are more stable compared with those of the epidermis, so the ink will mostly stay in place for a person’s lifetime.
If you know that eventually you want a full sleeve, then Gualteros advises coming up with the full-arm design ahead of time, instead of starting off with just a few sporadic tattoo ideas. This is true for both tribal-style tattoos as well as a series of more random, disconnected ones. “When you’re working with a blank canvas, you can really think through the entire composition to make it cohesive,” he says. “If you’re working with existing tattoos, you just have to try to make it as seamless as possible.”
Q-switched Frequency-doubled Nd:YAG: 532 nm. This laser creates a green light which is highly absorbed by red, yellow, and orange targets. Useful primarily for red and orange tattoo pigments, this wavelength is also highly absorbed by melanin (the chemical which gives skin color or tan) which makes the laser wavelength effective for age spot or sun spot removal. Nd:YAG lasers may cause hemoglobin absorption, leading to purpura (collection of blood under tissue in large areas), pinpoint bleeding, or whitening of the skin.
Remember that you will need touch ups. “Anything with a bold composition is usually easy to touch up and bring back to life, as is black and gray blending,” Dowdell says. “If you had a tattoo of a lion in black and gray—let's assume that the composition is solid but the application not so much—then it’s easier for us to go back into it and re-sculpt it into a legitimate piece of art and make it look better.”