Laser Eyebrow/Eyeliner Tattoo Removal Singapore -
My combination approach

Picosecond Laser

We use a second-generation triple-wavelength picosecond laser for tattoo removal.

Compared with standard nanosecond Nd:YAG lasers, it delivers higher peak power with picosecond pulses, which are considerably shorter. This produces a stronger photoacoustic effect (a shockwave that helps break up ink particles), which can reduce collateral damage to surrounding skin.

Shattering pigment more effectively may help reduce the number of sessions needed and lower the risk of complications such as scarring, though results vary by tattoo and individual.

The tattoo removal process uses three wavelengths, which together cover most colours of tattoo ink pigment:

• 1064 nm: targets dark green and black pigment
• 532 nm: targets red, orange, and yellow ink
• 694 nm: targets green and blue ink, which are typically harder to treat

Fractional CO2 Laser

One of the most popular choices in Singapore, the Ultrapulse fractional CO2 laser is absorbed by water in cells.

It produces ablation of a fraction of the skin, vaporising many tiny channels. Due to the short pulse duration, there is deep penetration of the skin with minimal collateral damage, reducing downtime and the risk of complications like post-inflammatory pigmentation.

It is used to pretreat the skin before shattering the tattoo pigments with a Q-switched laser. The results of this laser removal technique in Singapore highly depend on the doctor's experience using the laser.

Extracorporeal Shockwave Therapy

Extracorporeal Shockwave Therapy is another choice in Singapore.

It uses a hand-held device to transmit focused shockwave energy deep into the tissues. This enhances tattoo removal by increasing lymphatic drainage and metabolic activity, thereby accelerating the clearance of dermal pigment vacuoles produced by the picosecond laser and minimising side effects such as redness, swelling, and crusting.

Eyebrow/eyeliner tattoos and embroidery are becoming exceedingly commonplace in Singapore, from ubiquitous professional brow studios to the mushrooming of home-based salons.

Correspondingly, requests for removals have skyrocketed such that even salons are (illegally) offering 'laser removal' for eyebrow/eyeliner tattoos or embroidery. 

Common concerns when patients consult for eyebrow/eyeliner tattoo/embroidery laser removal are:

• Eye damage: Will there be eye damage since it is very close to the eyes?
• Pain: Will the pain be extreme/unbearable?
• Scarring or hair loss: will there be scarring or loss of hair (in the eyebrows/eyelashes)?
• Complete removal: Will the ink be completely removed?

Risk of eye damage during eyebrow/eyeliner tattoo or embroidery laser removal

Anytime a laser or light-based device is used, particularly near the eyes, there is a risk of visual damage.

It is essential to have the right equipment available to ensure safe and comfortable removal, which is not always available everywhere eyebrow/eyeliner tattoo/embroidery laser removal is offered. I've heard feedback from patients that they've had some difficulty locating clinics that actually have the right equipment ready.

Pain control

The eye area is very delicate and sensitive. Most patients can tolerate the procedure with strong numbing cream, but having options for more complete pain relief can make a huge difference to patient comfort as well as the outcome.

If the patient is too uncomfortable during the procedure, we wouldn't be able to accurately target the ink in the right area with the right power.

Having the right tools, techniques, and experience to perform appropriate nerve blocks will enable more optimal laser removal for eyebrow/eyeliner tattoos or embroidery in fewer sessions.

Risk of Scarring / Hair loss

on hair-bearing skin. Any scarring that develops can thus destroy the normal hair follicles, producing bald spots, making it even more important to minimise the risk of scarring.

Q-switched laser tattoo removal (whether using traditional nanosecond or newer picosecond lasers) uses ultrashort laser pulses to produce photoacoustic breakdown of tattoo pigment. This also creates superheated gas and steam trapped within the skin that causes collateral damage, resulting in blistering, increasing the risk of scarring and hair loss.

My approach is to use a combination of fractional ablative laser, q-switched picosecond laser (sometimes referred to as FracTAT), and shockwaves to address these pain points:

• Fractional laser drills micro-channels in the skin that act as pressure relief ducts, allowing superheated gases to escape without building up excessive pressure
• Picosecond q-switched laser (pico laser) uses short pulse durations that confine the laser energy better, resulting in less collateral damage
• Shockwave therapy enhances tattoo clearance by increasing lymphatic drainage and metabolic activity, minimising side effects such as redness, swelling, and crusting

Complete laser removal of eyebrow/eyeliner tattoo or embroidery

Ghosting or faint remnant tattoos are difficult to remove with nanosecond lasers or lower-powered picosecond lasers. These occur when there are:

• Pigments deep in the skin: inadequately powered lasers cannot penetrate deep enough to break up the remnant tattoo pigment
• Small remnant particles: the pulse duration of the laser is not short enough, resulting in inadequate photomechanical breakdown of the pigment
• Pigments shielded by scar tissue: scar tissue blocks laser energy from reaching the ink

The combination of high peak power from the pico laser and the increased penetration afforded by the fractional laser pretreatment is especially crucial for faint remnant tattoos that are hard to clear with traditional nanosecond laser treatment.

This higher safety margin and effectiveness allow for more aggressive treatment and better tattoo clearance in fewer sessions.

For tattoos that have faded to a green/blue/purple shade, a third wavelength is necessary to match the absorption of these colours. Most clinics produce this third wavelength through conversion, whereas the pico laser produces a native full-powered ruby wavelength that can deliver more energy for better removal of these colours.

Overall, combination treatment improves the efficacy, safety, and tolerability of laser tattoo removal in Singapore, and I strongly recommend it over conventional single Q-switched laser tattoo removal.

To my knowledge, it's not common for a triple combination technique to be used in Singapore for tattoo removal. Other than the actual techniques and machines used, the safety, speed, comfort, and effectiveness of the removal are also strongly dependent on the clinic and doctor, so choose wisely!

Dr Wan Chee Kwang

FOUNDER / MEDICAL DIRECTOR