Surgical excision surgically removes the tattoo. This procedure is typically performed on smaller tattoos and requires a dermatologic surgeon to remove the skin with a scalpel. The surgeon then closes the wound with stitches, making excision the most precise form of tattoo removal. Prepping for this is the same as preparing any surgery. Avoid sun exposure and refrain from taking any blood-thinning medications.

Side effects might include:

  • Skin discoloration
  • Burning and itching
  • A thick, raised scar that might appear three to six months after the surgery

Advantages of excision:

  • It’s highly effective if done correctly
  • It’s the fastest form of complete removal
  • It can be cheaper than other removal methods, depending on the size of the tattoo
  • Local anesthesia makes the procedure painless

Disadvantages of excision:

  • Those who have larger tattoos aren’t candidates
  • Some tattoo sizes may require skin grafting and more than one surgery
  • People may have a bad reaction to the anesthesia
  • The outcome depends on the surgeon’s skill level
  • Scarring is likely and can range from a small, thin line to a thick, raised scar
  • Anesthesia is costly and since tattoo removal is considered a cosmetic procedure, it’s unlikely that insurance will cover it

Likely the most extreme method of tattoo removal, excision is often sought out for religious reasons. For example, most Jewish cemeteries don’t allow those with tattoos to be buried. Those who follow the religion strictly must undergo excision because it’s the only acceptable form of tattoo removal, according to tradition.