Cairo Plastic Clinic 

Tattooing involves the placement of pigment into the skin's dermis. After initial injection, pigment is dispersed throughout a homogenized damaged layer down through the epidermis and upper dermis, in both of which the presence of foreign material activates the immune system's phagocytes to engulf the pigment particles. As healing proceeds, the damaged epidermis flakes away  while deeper in the skin granulation tissue forms, which is later converted to connective tissue by collagen growth. This mends the upper dermis, where pigment remains trapped within fibroblasts, ultimately concentrating in a layer just below the dermis/epidermis boundary. Its presence there is stable, but in the long term  the pigment tends to migrate deeper into the dermis, accounting for the degraded detail of old tattoos.

Dyes and pigments

A wide range of dyes and pigments can be used in tattoos, from inorganic materials like titanium dioxide and iron oxides to carbon black, azo dyes, and acridine, quinoline, phthalocyanine and naphthol derivatives, dyes made from ash, and other mixtures. Iron oxide pigments are used in greater extent in cosmetic tattooing. Modern tattooing inks are carbon-based pigments that have uses outside of commercial tattoo applications.

 TATTOO REMOVAL

This sometimes represents a conundrum to Plastic Surgeons. Some ink particles can be disolved by repeated Laser application, while others resistant to Laser must be removed surgically. Not infrequently, it is safer to avoid removal of the tattoo. Dr. Wilson remembers a lady who had her ex-boyfriend's name tattoed on her arm, and it was impossible to remove and her current boyfriend did not accept it. His advise was to change her boyfriend rather than mutilate her arm.

Tatoo in the arm of a 26 year old man: removed by Laser.

Tatoo in the back of a 19 year old woman: removed by Laser.

 
Tattoo in the eyebrow of a 45 year old woman: Previous removal by surgery ended up with a scar, that war almost erased by Laser.

Tattoo in the abdomen of a 29-year old woman: removed by surgery.

Tattoo in the arm of a 29-year old woman: removed by surgery in the form of tissue expansion, then excision. Note the appearance of the expanded arm, then almost invisible scar after removal of the expander and tattoo.