Plenty of El Paso has a tattoo it would rather not explain. Most of those people have also heard that removing one hurts more than getting it, costs a fortune, and leaves a scar.
Southwest Plastic Surgery hears all three at consult. The Med Spa treats tattoos with a PicoSure by Cynosure, the sessions are done by a trained esthetician and laser technician, and Dr. Frank Agullo sets the safety rules for how the laser is used. His position is simple: start low, ramp up, and tell patients the honest number of sessions before the first one.
Below, the practice’s esthetician and laser technician answers the questions patients ask most, in her own words. Dr. Agullo’s rulings on price, spacing and safety follow each answer.
How Laser Tattoo Removal Works
How does laser tattoo removal actually work?
Our esthetician and laser technician: “The laser goes through the skin to shatter and break apart the ink, and then the body absorbs it and it gets removed through the waste. That’s why it’s very important for the patient to stay hydrated before and after their session. That way, the ink gets flushed out through the body a little bit faster. Sometimes patients can feel flu-like symptoms after the treatment. That is also expected with laser tattoo removal, since your body is absorbing that ink. This happens more with larger tattoo pieces than smaller ones.”
The machine matters here. PicoSure is a picosecond laser, and its pulses are measured in trillionths of a second. That speed produces a pressure-wave effect on the ink rather than a heat effect, so the pigment shatters into smaller fragments with less collateral heat than the older Q-switched nanosecond lasers. It also covers a broader range of ink colors, including the blues and greens the older lasers historically struggled to clear.
On the flu-like symptoms, Dr. Agullo’s ruling is that they are real, mild and temporary. As the immune system flushes out the fragments, mild fatigue or a flu-like feeling can occur, most likely after a larger piece. A true fever or chills is not normal. That means the patient should call the clinic, because it can signal an infection or a stronger immune reaction.
How Many Sessions
How many sessions will I need?
Our esthetician and laser technician: “On average, about four to six sessions are recommended. It does depend on the tattoo itself, how old it is, and what colors were used in the tattoo.”
Four to six is the average, not a promise. An old, faded, single-color black tattoo sits at one end. A dense, colorful piece sits at the other.
How Far Apart the Sessions Are
Dr. Agullo’s spacing is every four to six weeks. Where a patient lands in that window depends on how they are recovering, the size of the tattoo, and their own schedule and availability.
The reason for the wait is healing, not scheduling.
How far apart are the sessions?
Our esthetician and laser technician: “Some blistering is expected after a laser tattoo removal session, so your skin does need to be completely healed before we go in for the next one.”
Blistered skin does not get lasered again. That is the rule.
Does It Hurt, and What the Practice Does About It
Does it hurt?
Our esthetician and laser technician: “Yes, tattoo removal can be a little bit spicy, a little bit uncomfortable, but we do help the patient become more comfortable during their session. We offer topical lidocaine, which is almost always used. We also offer injected lidocaine, which is a little bit better than the topical. Patients on average are more comfortable with the injection versus just topical.”
The third option is Pro-Nox, a type of inhaled anesthesia (nitrous oxide, laughing gas), which the practice offers at its main location.
“Pro-Nox is a laughing gas that makes you a little bit ditzy and makes you have a little bit more fun during your session, so you don’t think it is as bad.”
| Option | What it is | Notes from the practice |
|---|---|---|
| Topical lidocaine | Numbing cream applied before the session | Almost always used |
| Injected lidocaine | Local anesthetic injected under the tattoo | Patients are on average more comfortable with it than with topical alone |
| Pro-Nox | Inhaled nitrous oxide, laughing gas | Offered at the practice’s main location |
What Laser Tattoo Removal Costs in El Paso
Price is per treatment, and it is set by the size of the tattoo, not by a flat rate. As of this writing, the tiers at Southwest Plastic Surgery are:
| Tattoo size | Price per session |
|---|---|
| Extra small | $150 |
| Small | $250 |
| Medium | $350 |
| Large | $450 and up |
Total cost is the per-session price multiplied by the number of sessions, so a small tattoo that needs five sessions and a large one that needs four are very different bills. A consult is the only way to get an exact quote, because the technician has to see the tattoo to size it.
Prices can decrease when a package of sessions is purchased, and the practice runs occasional promotions on packages. The current monthly specials live on the Med Spa specials page. For the most current figures, rely on the fees page.
Which Ink Colors Are Stubborn
Do different ink colors matter?
Our esthetician and laser technician: “Yes. Usually sunset colors, red, orange, yellow, pink, or even green, can be more stubborn. More sessions might be needed if your tattoo contains these colors.”
Black responds best. The warm palette takes longer. A tattoo with sunset colors in it should expect more sessions than a plain black one, and the exact count is a consult conversation.
Scarring: The Honest Answer
Will it leave a scar, or remove the tattoo completely?
Our esthetician and laser technician: “Sometimes scarring is present after the ink is removed.”
Part of that scarring was there before the laser ever touched the skin. In her words: “It can leave behind scarring, but since you have the tattoo present, you don’t really notice the scarring until all the ink is removed.” A heavy-handed tattoo gun leaves texture under the ink, and the ink hides it until the ink is gone.
Dr. Agullo’s ruling goes one step further. Scarring and blistering are both possible after a session, and the practice does not promise the laser never scars. What keeps it rare is the way the energy is dialed in.
Dr. Agullo: “That is why we start most treatments at a lower energy level and ramp up as we see how the patient’s body and skin respond to the treatment.”
Who Is a Good Candidate
The practice’s best candidates share a few traits:
- They can commit to four to six sessions, spaced four to six weeks apart, which means a realistic timeline of several months rather than a single visit.
- They will stay hydrated before and after each session so the shattered ink clears faster.
- They accept that blistering is expected and that the skin has to heal fully between sessions.
- They understand that older, single-color black tattoos clear faster and that red, orange, yellow, pink and green may add sessions.
- They want an honest quote by size, not a flat number, and are willing to come in for a consult to get one.
Why Come to Southwest Plastic Surgery for It
Why come to Southwest Plastic Surgery for it?
Our esthetician and laser technician: “The laser technicians are fully trained here at Southwest Plastic Surgery. Not only are we fully trained, but we also have one of the best machines on the market, the PicoSure by Cynosure. The Pico gives faster results than other machines on the market.”
The other reason is the setting. Tattoo removal at the Southwest Plastic Surgery Med Spa happens inside a plastic surgery practice, with a double board-certified plastic surgeon behind the start-low, ramp-up rule and a clinic to call when a patient has a blister or a fever. The full menu of laser treatments is on the practice site.
Frequently Asked Questions
How many sessions does laser tattoo removal take?
About four to six on average, depending on the tattoo’s age, size and colors.
How much does tattoo removal cost in El Paso?
At Southwest Plastic Surgery, as of this writing, $150 for extra small, $250 for small, $350 for medium, and $450 and up for large, per session. Packages can lower the per-session price.
Does PicoSure tattoo removal hurt?
It can be, in the technician’s words, “a little bit spicy.” Topical lidocaine is almost always used, injected lidocaine is available and more comfortable, and Pro-Nox is offered at the main location.
How long between tattoo removal sessions?
Every four to six weeks, so the skin is completely healed before the next treatment.
Can red and yellow tattoo ink be removed?
Yes, but sunset colors (red, orange, yellow, pink, and even green) are more stubborn and may need more sessions than black ink.
Why do I feel tired or flu-like after a session?
The body is clearing shattered ink through the immune system, which can cause mild, temporary fatigue, especially after larger pieces. A true fever or chills is not normal and means you should call the clinic.
Why Choose Dr. Agullo
Dr. Frank Agullo is certified by the American Board of Plastic Surgery and the American Board of Surgery, completed his plastic surgery fellowship at the Mayo Clinic, and serves as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. He has been a Castle Connolly Top Doctor for thirteen consecutive years, 2014 through 2026. Southwest Plastic Surgery is his practice, and the Med Spa’s laser protocols are set under his supervision.
Ready to Talk?
Bring the tattoo to a consult. The technician sizes it, quotes it, and tells you how many sessions to expect before anyone turns the laser on.
Call (915) 590-7900, text 1-866-814-0038, or book online at swplasticsurgery.com. #StayBeautiful
Find Dr. Agullo at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
