If the tattoo is black or dark blue the tattoo removal is more efficient, but often the patient is left with an outline of pigment still remaining or with hypopigmentation of the skin area leaving a white area in the shape of the tattoo. Unfortunately the tattoo then looks moth eaten. Although more modern laser technology seems better at removing tattoos more efficiently, many patients are still unsatisfied with the results.
The only other alternative to laser tattoo removal would be to have the tattoo excised. The smaller the tattoo the easier it is to excise with a very fine linear scar. This is a fairly simple procedure and can be performed on all tattoos with complete removal and a resultant linear scar. If the tattoo is larger the tattoo can be removed over some months with serial excisions, waiting for the skin to loosen before doing the next excision. The resultant scar would still be a linear or straight scar.
For very large tattoos one can excise these with flap repairs or skin graft repairs. The last two options are not ideal but are possible depending on how much the person dislikes the tattoo. Smaller tattoos can be removed under a local anaesthetic in my office, larger tattoos are often removed under sedation as a day only procedure.