“What is the procedure and downtime for simple excision?”
“I’d like to know the difference between simple excision and other tattoo removal treatments.”
If these are questions on your mind, read on.
Simple excision is a type of tattoo removal treatment. The skin containing the tattoo or traditional ink tattoo (irezumi) is cut away, and the surrounding skin is pulled together and sutured.
On this page, we explain the procedure flow, downtime, and how simple excision compares with other tattoo removal treatments.
At IC Clinic, we propose a treatment approach tailored to each individual patient and provide care focused on achieving results. We take the time to carefully listen to your concerns and symptoms, so please book a consultation using the button below.
Table of Contents
- 1 What Is Simple Excision? A Surgical Option for Tattoo & Irezumi Removal
- 1.1 Simple Excision vs. Sequential (Split) Excision
- 1.2 How the Simple Excision Procedure Works
- 2 Downtime After Simple Excision | Taping Required for 3–6 Months Post-Surgery
- 3 Possible Side Effects of Simple Excision | Including Contracture and Hyperpigmentation
- 4 Other Tattoo & Irezumi Removal Treatments Besides Simple Excision
- 4.1 Dermabrasion | Abrading the Skin with a Grinder
- 4.2 Skin Grafting | Transplanting Skin to the Excised Area
- 4.3 Laser Treatment | Breaking Down Pigment with Laser Irradiation
- 5 Two Types of Laser Treatments for Tattoo & Irezumi Removal
- 5.1 Q-Switched Laser | Suitable for Tattoos of Various Colors
- 5.2 Pico Laser | Targets Fine Pigment Particles
- 6 Frequently Asked Questions About Simple Excision
- 6.1 Q. Is simple excision of a tattoo or irezumi covered by health insurance?
- 6.2 Q. Which is more painful — simple excision or laser treatment?
- 7 Simple Excision Is Well-Suited for Removing Small Tattoos & Irezumi
What Is Simple Excision? A Surgical Option for Tattoo & Irezumi Removal
Simple excision is a type of surgical procedure for removing tattoos and irezumi.
In simple excision, the skin over the entire affected area is excised, and the surrounding skin is pulled together and sutured closed. Because the pigment-bearing skin is physically removed, the tattoo or irezumi can be eliminated.
Since the surrounding skin needs to be stretched and drawn together, this procedure is well-suited to areas where the skin is soft and pliable, such as the thighs or upper arms. Conversely, in areas where the skin is firmer and less elastic — such as the ankle — the area that can be removed in a single session may be more limited.
Additionally, because there may not be sufficient surrounding skin to close the wound for larger tattoos or irezumi, this procedure is generally limited to the removal of smaller tattoos and irezumi.
Simple Excision vs. Sequential (Split) Excision
Besides simple excision, another surgical removal option is sequential (split) excision.
The table below compares simple excision and sequential excision.
| Simple Excision | Sequential (Split) Excision | |
|---|---|---|
| Size that can be removed | Smaller areas | Larger areas |
| Surgical method | The entire tattoo/irezumi is excised in one procedure | The tattoo/irezumi is excised in multiple stages |
| Suitable body areas | Areas with soft, pliable skin, such as the upper arms or thighs | Areas with firmer, less elastic skin, such as the ankle |
| Number of procedures | 1 session | Multiple sessions |
For larger tattoos that cannot be addressed by simple excision, “sequential excision” is performed, removing the tattoo in stages across multiple sessions.
By allowing time between each procedure for the skin to stretch and recover, even larger tattoos and irezumi can be removed with a comparatively clean outcome.
However, approximately 6 months to 1 year must elapse between procedures, which means the overall removal process can take a considerable length of time — a potential drawback to keep in mind.
How the Simple Excision Procedure Works
The simple excision procedure for tattoo removal generally proceeds as follows:
- Consultation
Your goals and wishes are discussed, and the details of the procedure are explained. - Treatment
Local anesthesia is applied to the treatment area, the skin bearing the tattoo or irezumi is excised, and the wound is sutured closed. - Post-procedure care
After the procedure, the treated area is disinfected and ointment is applied. The wound is covered with gauze, and sutures are removed approximately one week later.
The duration of the simple excision procedure depends on the size of the tattoo, but typically takes around 30 minutes as a general guide.
Some clinics also offer intravenous (IV) sedation. If you are uncomfortable with injections, we recommend asking about available anesthesia options during your consultation.
Downtime After Simple Excision | Taping Required for 3–6 Months Post-Surgery
Simple excision involves a downtime period of approximately 3 to 6 months, during which tape should be applied to the treated area to help prevent the scar from widening.
Showering is generally possible from immediately after the procedure, but please avoid getting the treated area wet. Other points to be mindful of after simple excision surgery include the following:
- Protect the treated area from sun exposure
- Avoid applying any irritation or pressure to the treated area
- Refrain from consuming alcohol for one week after the procedure
If you notice swelling, pain, or any other concerns in the treated area beyond what is listed above, please do not hesitate to consult your clinic.
Possible Side Effects of Simple Excision | Including Contracture and Hyperpigmentation
The following are potential side effects that may occur with simple excision surgery:
- Scarring / keloid formation
- Contracture
- Post-inflammatory hyperpigmentation
- Sensory abnormalities
- Restricted range of motion
- Acne / acneiform eruption
If you notice any of the above symptoms, additional treatment may be required. Please consult your clinic promptly.
Other Tattoo & Irezumi Removal Treatments Besides Simple Excision
In addition to simple excision, other treatments for removing tattoos and irezumi include dermabrasion, skin grafting, and laser treatment.
The table below compares simple excision with these other tattoo and irezumi removal options.
| Treatment | Simple Excision (Sequential Excision) |
Dermabrasion | Skin Grafting | Laser Treatment |
|---|---|---|---|---|
| Description | The affected skin is excised and the wound is sutured closed | The pigment-bearing skin is gradually abraded away | The affected skin is excised, and skin harvested from another area of the body is transplanted in its place | Laser energy is applied to break down the pigment |
| Advantages | Can remove pigment located in deeper layers of the skin | Comparatively shorter downtime and cleaner results | Can address larger tattoos and irezumi in a single procedure | Minimizes scarring to the surrounding skin |
| Disadvantages | Multiple procedures may be required for larger tattoos or irezumi | Complete ink removal may be more difficult depending on the condition of the skin | Scarring remains not only at the removal site but also at the donor site where skin was harvested | A treatment period of at least 6 months is typically required |
The following sections provide details on each tattoo and irezumi removal treatment other than simple excision.
Dermabrasion | Abrading the Skin with a Grinder
Dermabrasion is a treatment that removes tattoos and irezumi by using a specialized instrument called a grinder to abrade away the skin.
It can cover a relatively broad area, allowing for removal of larger tattoos and irezumi in a single procedure. A further advantage is its comparatively shorter downtime and cleaner post-treatment results.
On the other hand, abrading down to the deeper layers of the skin can be more challenging, which means some pigment may remain.
For more detailed information on dermabrasion, please refer to the dedicated page below.
What Is Dermabrasion? Pronunciation, Pain Levels for Irezumi & Tattoo Removal, and Health Insurance Coverage Explained
Skin Grafting | Transplanting Skin to the Excised Area
Skin grafting — also referred to as a split-thickness or full-thickness skin graft procedure — involves excising the tattooed or irezumi-bearing skin and transplanting skin harvested from a healthy area of the body to cover the wound.
One advantage is that this approach can address tattoos and irezumi where the pigment has penetrated into deeper layers of the skin. It is also possible to remove a larger tattooed area in a single procedure.
On the other hand, a drawback is that scarring remains not only at the removal site, but also at the donor site from which the skin was harvested.
For more detailed information on skin grafting, please refer to the dedicated page below.
What Is Skin Grafting? Procedure for Tattoo & Irezumi Removal, Pain, and Side Effects Explained
Laser Treatment | Breaking Down Pigment with Laser Irradiation
Laser treatment is a procedure that removes tattoos and irezumi by directing laser energy at the affected area.
The laser energy works to break down the pigment, gradually fading the tattoo or irezumi. After each session, pigment breakdown continues over approximately one month, so it is important not to expect immediate results and to allow the process to progress at its own pace.
After laser treatment, the irradiated area may feel warm, so post-treatment care such as cooling is recommended.
A key advantage of laser treatment is that it does not damage the surrounding skin outside the targeted area, helping to minimize scarring. It can also be applied regardless of the body part or the size of the tattoo.
However, one disadvantage is that the interval between sessions tends to be longer compared with other treatment options. While most other removal methods can typically address the tattoo in a single day, laser treatment generally requires a treatment period of approximately 6 months or more.
Two Types of Laser Treatments for Tattoo & Irezumi Removal
The two main types of laser treatments used for tattoo and irezumi removal are:
- Q-Switched Laser
- Pico Laser
The following sections describe the characteristics, discomfort levels, and typical number of sessions for each.
Q-Switched Laser | Suitable for Tattoos of Various Colors
Q-switched lasers include YAG lasers and ruby lasers, among which the Q-switched YAG laser is particularly well-suited for tattoo removal.
A notable feature of the Q-switched YAG laser is its ability to switch between two wavelengths — 532 nm and 1064 nm. This allows it to target pigments such as red and yellow that have traditionally been more difficult to address with conventional laser treatments.
For more detailed information on Q-switched lasers, please refer to the dedicated page below.
What Is the Q-Switched YAG Laser (Spectra)? Three Treatment Benefits for Conditions Including Melasma Removal, and What to Expect After Treatment
Pico Laser | Targets Fine Pigment Particles
Pico laser is a laser treatment device that delivers energy in pulses measured in picoseconds (one trillionth of a second).
The pico laser is capable of breaking down even fine ink particles. As a result, tattoo and irezumi removal may be completed in fewer sessions compared with conventional laser treatments.
For more detailed information on pico laser, please refer to the dedicated page below.
What Is Pico Laser? Three Irradiation Modes, Expected Outcomes, and Potential Risks Explained
Frequently Asked Questions About Simple Excision
Below, we have compiled answers to frequently asked questions about simple excision.
Q. Is simple excision of a tattoo or irezumi covered by health insurance?
Simple excision performed for the purpose of removing a tattoo or irezumi is not covered by health insurance.
As such, the full cost of treatment is the patient’s responsibility.
Excision procedures that may qualify for health insurance coverage include the removal of moles that obstruct the visual field or cause functional problems.
Q. Which is more painful — simple excision or laser treatment?
In terms of discomfort during the procedure itself, laser treatment tends to involve more noticeable discomfort. Depending on the type of laser and the output settings, patients often describe a sensation similar to being snapped with a rubber band.
With simple excision, anesthesia is administered before the procedure, so discomfort during the treatment itself is generally minimal. However, once the anesthesia wears off after surgery, some pain may be felt.
Additionally, if swelling or bruising occurs following simple excision, post-operative discomfort may persist for a longer period. Pain after the procedure can generally be managed with oral pain medication.
Simple Excision Is Well-Suited for Removing Small Tattoos & Irezumi
Simple excision is a type of treatment for removing tattoos and irezumi. The tattooed or inked skin is excised, and the surrounding skin is sutured together to close the wound.
Key features of simple excision include the following three points:
- Smaller tattoos and irezumi can be removed in a single procedure
- While a suture scar remains, it is generally less obvious than the original tattoo or irezumi
- Well-suited for areas of the body where the skin is soft and pliable
Smaller tattoos and irezumi can be removed in a single procedure. The resulting scar is relatively straightforward in appearance, making it less obvious to others that a tattoo or irezumi was ever present.
On the other hand, for those who wish to minimize post-treatment scarring and prioritize a cleaner aesthetic outcome, laser-based tattoo and irezumi removal may be worth considering.
At IC Clinic, we propose a treatment approach tailored to each individual patient and provide care focused on achieving results. We take the time to carefully listen to your concerns and symptoms, so please book a consultation using the button below.
