Washington Institute of Dermatologic Laser Surgery is known worldwide as being a leader in laser skin surgery. We were one of the first practices in the world to offer PicoWay laser, an FDA-cleared laser treatment for the removal of tattoos and pigmented lesions. PicoWay laser incorporates picosecond (one trillionth of a second) pulse durations to generate ultra-short pulses with very high peak powers of laser energy on the skin. A strong photo-mechanical impact occurs that results in the fracturing of tattoo ink or pigment particles in the skin.
One small Greek study showed that the R20 method—four passes with the laser, twenty minutes apart—caused more breaking up of the ink than the conventional method without more scarring or adverse effects. However, this study was performed on a very small patient population (12 patients total), using the weakest of the QS lasers, the 755 nm Alexandrite laser. One of the other main problems with this study was the fact that more than half of the 18 tattoos removed were not professional and amateur tattoos are always easier to remove. Proof of concept studies are underway, but many laser experts advise against the R20 method using the more modern and powerful tattoo removal lasers available at most offices as an increase in adverse side effects including scarring and dischromia is likely. Patients should inquire about the laser being used if the R20 treatment method is offered by a facility as it is usually only offered by clinics that are using the weak 755 nm Alexandrite as opposed to the more powerful and versatile devices that are more commonly used. Moreover, dermatologists offering the R20 method should inform patients that it just one alternative to proven protocols and is not a gold standard treatment method to remove tattoos.
More important than ever is finding an artist who specializes in the kind of tattoo you want. Gualteros, for example, specializes in realism tattoos, as well deep black designs, and that’s what most of his customers want from him. He says to shop around with this as your biggest requirement, instead of shopping for prices. After all, you’ll be wearing this thing prominently for all your days, so it’s not worth bargaining. “Set up a design consultation to talk through your ideas with the artist,” Gualteros says. “Play around with a sketch, and if everything goes well—if artist and client are on the same page—set up the appointment and get it going.”
Sleeves are not easily covered unless you have a long sleeved shirt on. Some people choose to stop their sleeve before their watch so that people in the workforce can’t see it, even when they shake someone’s hand. Other people choose to extend the work past their wrists and onto their hands. It’s a personal preference and different for every individual.