Another popular method of tattoo removal especially when the dyed area is small is by excision. The advantage of this method is that the entire tattoo can be removed. With larger tattoos, however, it may be necessary to excise in stages, removing the center of it initially and the sides at a later date.

Excision involves an injection of a local anesthetic to numb the area after which the tattoo is removed surgically. The edges are then brought together and sutured. With this procedure, there is minimal bleeding which is easily controlled with electrocautery. In some cases involving large tattoos, a skin graft taken from another part of the body may be necessary.