Tissue Expansion for Tattoo Removal

Hi Doctor,

I recently (about 3 months ago) got a large tattoo on my calf (about 4" x 10").  I spent 10 years thinking about it and thought I was ready, and I absolutely cannot stand it now (the artist did a great job, but it is too big and I really just hate it).  I have been for 2 laser consultations and was told due to the size and color (lots of green) that it would take about 20 sessions and about 2 years, and will most likely leave visible pigment.  I did have some shading removed by laser at the second consult and it took two weeks for the blisters and scabs to heal.  I am not sure if I could handle that every 5 weeks for 2 years (Especially since the area is so large).  This has taken a real toll on my emotionally and I have started seeing a counselor and was put on anti-depressants.  I am now looking into tissue expansion surgery to have the tattoo excised (I have a consult in a few weeks with a local plastic surgoen). I was wondering if you have any experience with this and what major complications I could expect.  Also, how much do tissue expanders limit my amount of activity (if it is on my lower leg)?  I do know to expect a long scar, but I am thinking it should be relatively linear.   Are there any questions you recommend that I ask to the plastic surgeon when I meet with him?

Thank you so much for your time and expert advice!

[Howard Rosenberg, MD]

Use of tissue expansion is one way of handling this problem.  If the tattoo is very large, the first issue is whether sufficient skin can be generated from the expansion to cover the complete excision of the tattooed skin.  It will probably take three months to allow sufficient fime to expand the normal adjacent tissue and you will definitely have a very weird deformity to contend with while expandsion is progressing.  Finally, you will definitely have a long linear scar where the tattooed skin is removed and replaced with the expanded skin.  The expanded skin will have a different quality than normal skin.  Your decision will ultimately come down to whether expansion is a better procedure to continued laser therapy.