Nd:YAG Laser or Pico Toning for Tattoo Removal

Ink Regret

Lasers are considered the gold standard in tattoo removal. They are by far the safest and most effective way to deal with unwanted tattoos, and it is the only way to go if you want to have appreciable result without damaging the skin over which the tattoo was inked.

A tattoo seemed like a good idea at the moment when you wanted to get yourself some skin graffiti, but tattoo regret is very common. Studies show that 1 in 4 people have considered having their tattoos removed. Tattoos may put a strain on interpersonal relationships, affect employment opportunities or simply grow out of fashion. Other times, we have patients who request to lighten their existing tattoos in order to have them revised with a new design. Some clients do not like their eyebrow tattoos and request to have them lasered off. The reasons for wanting to remove a tattoo are endless, and we are here to help.

What kind of laser is used?
In our clinic we use the tried and tested Nd:YAG Laser Q-switched Nd:yag (Yag laser as some call it). This was the gold standard for tattoo removal and is still widely requested in our clinic due to the reliability, and relatively lower costs involved. The downside is that it may require more sessions than the newer Picosure Picosecond laser. The Medlite laser removes black and red inks best, but does not work so well with green, blues, purple hues. These colours are best treated with the newer Picosure picosecond laser.

The advent of modern Q switched Nd:Yag lasers in the last decade (and recently the Picosure picosecond) has permitted the removal of most tattoo inks with a very low risk of scarring.

Improved Photoacoustic Effect of the Discovery PICO Plus Laser. Pigments are pulverized instead of large piece fragmentation
with traditional Q-Switched Lasers, resulting in more efficient tattoo clearance and overall reduction in number of treatment
sessions required.

The new generation of Picosecond lasers are able to fire laser beams with even shorter pulse durations in the picosecond (trillionth of a second) duration. It is an improved technology from traditional Q-switched Nd:Yag lasers which fire laser beams in the nanosecond (billionth of a second) duration. Picosecond pulsing enables the “Pico Dusting Effect”, which is pulverization of tattoo pigment at high pressure. This photo acoustic effect breaks tattoo inks into a fine dust cloud, with dust particles tinier than those fragmented by traditional nanosecond Nd:Yag lasers. Pulverized pigments are absorbed much more efficiently, resulting in speedier elimination of the ink particles by the body. This means you need less treatment sessions to remove a tattoo compared with the traditional types of laser. The ultra-short bursts also mean even lesser thermal damage to surrounding normal tissue, thus there is lesser redness and swelling compared to its traditional counterpart, dramatically reducing the risks of scarring.

The Cynosure Picosure laser system was the world’s first picosecond laser to receive FDA approval for the removal of tattoos and benign pigmented lesions. (There have been other picosecond lasers to receive FDA clearance since).

Even the most challenging blue, green and purple inks, or stubborn tattoos previously treated by conventional lasers can be effectively removed with this laser. Individual variation can occur with any laser tattoo treatment. Our doctor will advise you on suitability, success rates and expected outcomes of our treatments.


How does laser tattoo removal work?
Tattoos are removed by directing laser energy at the tattooed area in very short pulses, passing through the outer layer of the skin and directly targeting the tattoo ink. The laser selectively destroys the tattoo ink. Over the next few weeks, the body’s scavenger cells remove pigment residues, resulting in lightening of the tattoo. It takes time for the treated area to heal as your body’s immune system works overtime to flush the ink away. Generally, it can be repeated at intervals of 4 to 6 weeks.

Is the process painful?
A topical anesthetic cream is routinely applied for 20 minutes prior to treatment. A gentle stream of Zimmer cool air is continuously blown at the treatment area. This not only protects the treatment area but increases comfort levels throughout the laser treatment. There is some discomfort during the procedure, but it is usually very well tolerated. Patients describe the sensation of a rubber band snapping on the skin. In some cases, a local anaesthetic can be injected prior, to make the treatment even more comfortable.

How many treatment sessions will it take to remove the tattoo?
No two tattoos are alike and we are not talking about the aesthetics aspect of them. There are many factors that govern how a tattoo will look after it’s healed, and just as many that determine its ease or difficulty of removal. The number of treatments required to remove a tattoo depends upon several factors including size, location, color, depth, how the tattoo was applied, the length of time it has been on the skin, and the patient’s individual skin type (Kirby-Desai Tattoo Removal Scale helps to estimate number of sessions needed). Most patients will require around 5 to 8 treatments sessions upwards, while others will appreciate satisfactory lightening in 3 or 4 sessions upwards. In some cases, they might need more than 12 treatment sessions if there is considerable skin disfigurement or layered tattoos.

How does the color of my tattoo affect the outcome?
The type and quality of the ink used as well as the color itself will affect the outcome of laser tattoo removal. Some compounds in ink, such as beryllium, are hard to remove. Contrary to what you might think, darker inks are actually easier to remove than lighter inks, with black and dark blue ink being the easiest to remove. Most traditional lasers such as the Q switched Nd:Yag struggle to remove green, pale blue, and yellow, but the newer generation of picosecond lasers can tackle these colours much more effectively. With the Picosure laser, this has been reduced to half the original number of sessions required, and even stubborn tattoos have shown to respond remarkably well. Individual variation can occur.

How much will it cost and how do I make an appointment?
Pricing depends on the size and complexity of the tattoo and start from about $190 upwards. WhatsApp a photo of your tattoo, along with dimensions in cm for a quote today: +65-8223-0609 or email us: info@freia.sg

Will the tattoo completely disappear?
Most of the time, yes. However, it is very important to know that over 100 tattoo inks are in use worldwide. Not knowing which tattoo ink, how deep or how much was used, makes it difficult to predict with 100% certainty. The Kirby-Desai scale gives a good estimation of number of sessions required and the likelihood of complete clearance.

Giving back to society

Freia Medical has been an active participant of the Yellow Ribbon Project, which aims to raise awareness of the need to give second chances to ex-offenders and their families. Since 2010, our medical director, Dr. Harold Ma, has volunteered his expertise to perform pro-bono Laser Tattoo Removal for ex-offenders in support of their rehabilitation and reintegration journey back to society.

It may have been a great idea to get that tattoo in that moment. But circumstance change.

We understand. And we can help.

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