Picosecond laser aka Picosure - the future of tattoo removal?

[CampB]

@SStu @Mike Panic

hi guys,

finished my second session yesterday.

i let my doctor know about my healing process; about the blistering, etc and he said that's totally normal and that the blistering will lessen as we progress.

firing at 10hz, about 23K total pulses (but I'm not sure if that's including my neck).

my neck took about three minutes; sleeve = 36 minutes; wrists a few seconds (probably like 15 seconds total).

so it was about 39 minute session.

i know the before pictures are important for comparison (and the before pictures are with my dr, i don't have any personal ones) but i'll post pictures after six weeks from this second session i had and you guys can start seeing progress yourselves since the first session.

i'll report back in six weeks!

[Mike Panic]

Wow. Longest I've treated anyone is 19 minutes. That's brutal. Drink water. Lots. Till it hurts. It will help you. Also eat well today and tomorrow.

[CampB]

@Mike Panic will do. thanks! :)

[Math]

I have had some picosure treatment on my second set of knuckles. I find it painfull, but that is probably because of where the tattoo is. As far are the removal, it works so much better, the results are really good compared to the Active Q-switch I got lasered with before

[YOMONEY]

theres a lot of picosure review action going on over at RealSelf. some of it really good, some of it crap. I think it all comes down to the tech and if he/she is skilled or not, and from what Im gathering a lot of them aren't and are also afraid of turning up the machine. for what its worth I also hear healing time is a lot quicker with picosure, theres less swelling, and it doesn't hurt as much, all things I don't really care about especially for 2x-3x the price of q-switch.

[Wraith]

if you guys haven't seen it ... here is my blog on realself about my laserjourney :)

Tattoo Removal of a Full Sleeve and a Lowerleg Sleeve / Chest, Stomach and Neck with Picosure- Germany, DE - PicoSure review - RealSelf

[YOMONEY]

shit, man. that thing got annihilated.

[Mike Panic]

theres a lot of picosure review action going on over at RealSelf. some of it really good, some of it crap. I think it all comes down to the tech and if he/she is skilled or not, and from what Im gathering a lot of them aren't and are also afraid of turning up the machine. for what its worth I also hear healing time is a lot quicker with picosure, theres less swelling, and it doesn't hurt as much, all things I don't really care about especially for 2x-3x the price of q-switch.

Some of this I agree with, some I really don't. Specifically,

I think it all comes down to the tech and if he/she is skilled or not

90% of the tattoo removal process success is a direct result of your immune system. The other 10% is a mix of pigments used and technique of artist. I've covered this several times before. The tech / doctors job is to safely and efficiently fade your tattoo.

a lot of them aren't and are also afraid of turning up the machine.

This is just false. Yes, a small percentage of people out there will milk clients for an extra treatment or two by playing it too safe and not being aggressive enough. Here's the preface to what I'm about to share. I was tagged in an Instagram photo and asked for an opinion, you can read my comments with the original poster and another certified laser tech. The client is not mine (they live in a different country) and I offered no aftercare help.

Instagram

My gut feeling is that the tech was too aggressive with their first treatment. In the comments the person says she made a video of the process and posted it to YouTube, I've seen it and don't believe the technique is wrong, although perhaps a "little" too slow, but here's the thing. That type of blistering is not normal. It's coming from either two much energy or impurities / foreign objects in the pigment, I'm guessing on the first. Secondly, you can see after 1 treatment the level of hypo-pigmentation in the surrounding skin, that is to say the lightening of her skin tone. That is not acceptable to me, and it shouldn't be to anyone. Yes, hypo-pigmentation is possible with any laser treatment, but to see that much after just 1 treatment is NOT good, and I'm seeing this fairly often with clients treated by a Picosure.

I also hear healing time is a lot quicker with picosure, there's less swelling, and it doesn't hurt as much

Healing time is healing time, it's all about the same, but the level of fading can be 5-30% greater with a Pico due to the shorter light bursts / more efficient at breaking down pigment. Swelling is dependent upon lots of factors, including location, total size, body mass of client and technique of the operator. elbows to fingers and ankles to toes always swell more and take longer to heal due to location. The further away from the heart, the harder it is to pump blood there. This is true with any wound.

all things I don't really care about especially for 2x-3x the price of q-switch.

Ironically, the Cynosure sales rep seems to think otherwise, and they are pushing sales hard and saying that people will pay a premium to get something gone faster. Price still matters, so does proper ability to heal and heal well without issues.

@Wraith - thanks for taking the time to do that!!

[YOMONEY]

mike, you've probably taught my the most about the lasering process out of anybody or the entire internet put togather, but I gotta go straight to the horses mouth on this one.. Picosure and Medlite on 3/4 Sleeve - Dallas, TX - PicoSure review - RealSelf

- - - Updated - - -

**although his views, and other reviews I read, could be because of other reasons, such as being further a long in their treatments before using picosure, etc.

but I still think that the tech needs to be skilled or else youre just waisting money (compare the results somebody like mike driver gets to dr. tattoff) or will end up hurt like that foot in the instagram picture.

[lasereast]

I would like to ask you because you are physician then what is surgical removal and how it is being processed?

[CampB]

update! @Mike Panic @YOMONEY

below are pictures after two pico sessions; right before going into my third session today.

laser time was considerably less this time considering all my shading's gone so there's less area to go over. really bummed about all the hyperpigmentation though.

so after being less than impressed with the results after my first session, i insisted my dr. to really burn this shit up (he had strongly advised against the settings i requested but i wouldn't have it any other way) so for my neck, he went from 3.7mm to 3.2 and 3.7 to 3.6 for my sleeve and wrists. results were amazing but left me with some scarring on my neck. so this time this is what we did:

neck: 3.5mm // 2.08 J/cm2 // 10 hz // 2 minutes

sleeve and wrists: 3.6mm // 1.96 J/cm2 // 10 hz // 27 minutes

total pulses: 2208

for the red on Poison's face and lips, we use YAG

you can probably tell the first photo is what my Lady looked like before i started treatments. :(

[/img]

[Gregor]

Wow really like that poison tattoo , thats a shame you have to lose it :(

[YOMONEY]

"i insisted my dr. to really burn this shit up (he had strongly advised against the settings i requested but i wouldn't have it any other way)" that made me crack up for some reason. thanks for sharing these pictures..

- - - Updated - - -

those results look really good actually compared to the last pictures you posted. whether that would have happened with a qswitch who knows!

[CampB]

"i insisted my dr. to really burn this shit up (he had strongly advised against the settings i requested but i wouldn't have it any other way)" that made me crack up for some reason. thanks for sharing these pictures..

- - - Updated - - -

those results look really good actually compared to the last pictures you posted. whether that would have happened with a qswitch who knows!

keke, yea - my dr. was a little annoyed at my persistence but i just really wasnt happy after the first session; real change happened after the second time.

he showed me some side by side pictures of ppl he's treated who had half their tattoos done with qswitch and the other half with pico and the difference was pretty mind blowing. made me glad i started with pico.

- - - Updated - - -

Wow really like that poison tattoo , thats a shame you have to lose it :(

thanks! it was done by Adam Rosenthal at Th'ink Tank Tattoos in Denver, CO. she's so lovely. well... was...

- - - Updated - - -

also, this time 'round, there was less frosting but the dr. said it's still reacting pretty well so we didn't go up although i think next time (which is in 8 weeks) we'll have to.

it's been about 24hrs since my last session and although i'm still hella swollen and red - i have very, very minimal blistering. yays.

[YOMONEY]

wow, yeah, im still on the fence about picosure (I was just saying to mike above about the heal time and swelling/larger areas being treated). but what ive seen and heard from realself and other reviews im convinced its pretty dope. but if I were just going for coverup I wouldn't bother wasting the extra money. what is your endgame? competele removal? I might be wrong, but from my observations, qswitch is good for any fading for coverup procedure, where as a picosure might be the best for a complete removal?

[CampB]

wow, yeah, im still on the fence about picosure (I was just saying to mike above about the heal time and swelling/larger areas being treated). but what ive seen and heard from realself and other reviews im convinced its pretty dope. but if I were just going for coverup I wouldn't bother wasting the extra money. what is your endgame? competele removal? I might be wrong, but from my observations, qswitch is good for any fading for coverup procedure, where as a picosure might be the best for a complete removal?

yea, im going for complete removal of the sleeve, wrists, and neck. the neck is my biggest concern as it's really the only thing keeping me from a career in the US military. the sleeve - i just don't like anymore and the wrists could become a problem if the military adopts yet another new tattoo policy. bleh.

[Chopper]

I'm trying to find a place offering the Picosure in SW Ohio. The search in the link provided in the first post is inaccurate (I called the location in Cincinnati, who do NOT have one....they mentioned a place in Columbus, but nothing comes up).

Anyone know who in Columbus has one or of another one in this area of Ohio?

Thanks much

[SStu]

I don't, but often you can get leads from major tattoo shops in the area.

[vik2001]

is there any difference in pain between yag and pico? also recovery in terms of blistering between the two?

[keydude]

This really excites me! I'm looking to get a poor tattoo lightened so I can they cover that area with a half sleeve of a similar but excellent tattoo :)