PiQo4 makes safe and reliable pico-second and nano-second laser treatments available to all skin types – with more power and better results than the competition.

The PiQo4 laser is a picosecond laser, much like the PicoSure and PicoWay lasers. However, the PiQo4 laser is the first of it’s kind – the only FDA-Approved picosecond laser to offer 4 wavelengths, and much more powerful than any other laser on the market (we had to get an electrician to specially wire our office for this laser because it needs so much more power than any other laser we own – and we own over 50 lasers).

PiQo4 is safe on all skin tones and typesThe most important part to us is that it’s much more effective (taking about 40% fewer treatments to achieve the same result), and yet it’s safe on all skin tones. No matter the color of your skin, or the color of the tattoo or discoloration you want to be removed, the PiQo4 delivers fast, effective, and safe treatments.

What is the PiQ04 Laser?

PiQo4-New-JerseyThe NaturaLase PiQo4 laser is the highest-powered laser currently approved for use by the FDA. It is an Nd:Y AG 1064 Q-Switched Laser with four wavelengths of light available in a wide range of settings to treat unwanted tattoos, skin discolorations, and general skin resurfacing concerns. This laser has quickly earned world reknown for its ability to remove even the trickiest of tattoo inks on all skin types in far fewer treatments than anything else on the market.

A Note on Why You Won’t See This Laser Available Everywhere

Only a skilled laser specialist who understands the physics of cosmetic lasers can really use the PiQo4 safely, and to its full advantages.

The PiQo4 offers an amazing range of settings – including spot size, fluence (energy), wavelength blend, and pulse duration. Together, these settings can be used to safely and effectively treat any skin tone for a variety of concerns, but to do so requires an in-depth understanding of lasers. This is not a basic system with pre-sets – there are no training wheels on this laser. And because it’s so high-powered, most doctors who aren’t able to use this platform safely and effectively aren’t adding it to their practice’s offerings. That’s why you won’t find too many practices with this laser.

What Does It Treat?

The PiQo4 laser can be used to treat a variety of concerns, including:

  • tattoos of all colors on all skin types and tones
  • acne scars and surgical scars
  • cafe-au-lait birthmarks
  • age spots and skin discolorations
  • Lentigines (liver spots)
  • general skin tone and brightness
  • fine lines and wrinkles
  • sun damage and brown spots

About PiQo4 Tattoo Removal

Reflections has been a leader in tattoo removal for over 10 years now. Dr. Chasin is one of the world’s foremost authorities on the subject, often teaching other physicians and working hand-in-hand with the product development teams at top laser manufacturers, to ensure new laser technologies are not being made to provide the most effective treatments, but being used by physicians in the most effective and safe ways possible. The PiQo4 was the first truly significant break-through in tattoo removal technology in at least 5 years.

African American male tattoo removal in NJIn the beginning, tattoo removal was very limited. The lasers available were really only good at removing designs made of a dark blue, black or green ink on those with lighter complexions (skin type I-III). Then, new lasers came on to the market that made it easier to target red tones and treat patients with a wider range of skin tones, but treating darker skin tones often meant turning down the laser’s power settings, which meant less effective treatments, and a more expensive and lengthy process overall for those patients. What’s different about PiQo4 is that we can treat every single color of tattoo ink on every single skin type (1-6), without turning down the energy – in fact, we’re using much more aggressive energy settings on everyone with this laser.

The PiQo4 also offers us the ability to treat with both nanosecond and picosecond pulse durations. This means in a single session, we can make more progress on completely removing a tattoo, still using those higher power settings.

The PiQo4 is both a nanosecond AND a picosecond laser

In studies, the PiQo4 has shown to require up to 40% fewer treatment sessions than competitors1. That doesn’t mean it’s the only laser we use – we often mix the PiQo4 with our other tattoo removal lasers, including Fraxel and Ruby, but we do see our patients needing far fewer treatments now that we have the PiQo4 doing a lot of the heavy lifting.

About PicoFractional™

PiQo4 has been developing a fractional skin rejuvenation treatment for the past year or so, and we’ve been helping them test and fine-tune this application. Our medical assistant Kelly was one of the first to test this new treatment, and she experienced significant results for clearing away some old acne scars. Now that the treatment has been fine-tuned and is available to the public, we’re happy to say we see several advantages that make this unique skin rejuvenation a great addition to our collection of skin resurfacing technologies.

Advantages of PicoFractional™ Skin Rejuvenation, in comparison to other popular skin resurfacing lasers, like Fraxel:

  1. Safe for all skin tones, even at its highest settings. Skin types 3-6 (Asian, Middle Eastern, Indian, Mediterranean, Hispanic, Native American, African, and ethnicities with similar olive, brown, or dark skin tones) have a risk of skin pigmentation change inherent in any treatment that heats the top layers of the skin. PiQo4 converts its laser energy into acoustic soundwave energy in the PicoFractional treatment, removing this risk completely.
  2. No downtime. With the PiQo4, mild redness lasts about an hour or two after treatment, as compared to several days to weeks with Fraxel and Co2 lasers.
  3. Fractional treatment zones mean faster results. All non-ablative fractional skin rejuvenation procedures offer a greatly reduced recovery because they only treat a fraction of the skin with each session. However, traditionally there was a trade-off in the efficacy of these treatments in order to achieve this shortened downtime. The PiQo4 doesn’t require us to reduce the power or effectiveness of its treatments, so patients get that shorter recovery and much faster results, and the results we can achieve in a single treatment are profound.

Is the PiQo4 Laser Right for You?

tattoo removal for asian skin in njOur practice continues to house New Jersey’s largest collection of the most effective, cutting-edge laser and cosmetic procedure devices. PiQo4 is not the right laser for all patients or all situations. In fact, we believe there is no one laser or tool that can ever be the best at everything – each person and situation is unique, and our recommendations will vary accordingly.

However, the PiQo4 laser is typically a good option for most patients. It is not recommended that you have treatment while pregnant or directly before or after tanning.
We require you to wait 2 weeks after tanning and ask that you protect your skin from prolonged sun exposure for 2 weeks after treatment. Being tan, which can last months or years after sun exposure, does not mean you can’t be treated by the PiQo4 for either tattoo removal or skin rejuvenation.

Consultation and Treatment


The first step is a complimentary consultation with one of our cosmetic physicians. This can be scheduled at either of our offices, which are located in Livingston, New Jersey, and in the Martinsville section of Bridgewater, NJ. During your consultation we’ll discuss your cosmetic concerns, budget, ability to take time off from work and social activities(or not), and other factors that will help us create a customized treatment plan suited to your needs, that will get you the best possible results. Often, our treatment plans can be staged and utilize multiple lasers and other tools. This makes your treatment plan affordable and easy to fit into your busy life.

At the end of your consultation, you’ll be presented with a printed copy of your treatment plan, which will include an itemized price quote. If you choose to move forward with treatment, we can often accommodate treatment the same day. Those who opt to purchase tattoo removal treatment the same day as their consult are eligible to receive a 25% discount on their first treatment, even if they choose to schedule that treatment for a later date. For more details on this limited-time offer, please give our offices a call.

Financing is available for packages or treatments totaling $1000 or more (for this laser’s pricing info, jump to the cost section below). You can apply for financing prior to your appointment here.

The Treatment

Tattoo removal treatment with the PiQo4 laser is extremely quick, usually lasting no more than 1-2 minutes. However, for some patients, the tattoo removal process can be painful. We offer two types of numbing to tattoo removal patients, to ensure the treatment is comfortable. It’s always your choice as a patient to decide what, if any, numbing you’d like to use. Jump to the section on numbing below for more information on how we are able to ensure your treatment is not painful using numbing medications.

The video above shows just how quickly the PiQo4 laser treats a very large, dark star that covered this muscular male’s shoulder. The results in the video show how powerful a single treatment with the PiQo4 can be.

The PicoFractional treatment usually takes around 10-15 minutes to complete the entire face. In this mode, the laser still shoots extremely short duration pulses, but it also makes use of a scanning technology to ensure it’s not treating over the same area and is properly spacing apart the fractions of treated skin, for optimal results. Patients tend not to need numbing during this treatment, but it is available for those who want it.

Recovery and Results

After your tattoo removal treatment, it is normal to have white frosting over the tattoo. Your tattoo may also feel warm and swollen and the skin may be red and inflamed, much like after a sunburn. Our doctors will instruct you to care for your treated tattoo just like you would a new tattoo – protect it from the sun, don’t pick at it, and generally keep the skin clean and moisturized.

permanent makeup removal and correction
Click the image above to watch a video of her treatment and learn more about this specific case.

After a PicoFractional treatment, your skin may be slightly red for up to an hour or two. Afterward, you should not experience any side effects or downtime. You can cover this redness with makeup immediately following treatment, and you can return to normal activities and skincare routines right away.

Cost of PiQo4 Laser Treatment

Tattoo removal at our offices is priced by the size of the tattoo. This pricing model allows our physicians to adjust the treatments and utilize our full range of tattoo removal lasers to their best advantage. Almost every patient will need 4-6 treatments to remove their tattoo completely, and often the process will include 2-4 different lasers, so most patients purchase a package of treatments to take advantage of the cost savings we offer on packages.

Piqo4 laser tattoo treatment with 40% fewer sessionsWith the PiQo4, we have had a few patients who were able to completely remove their tattoo without using up all of the treatments they had purchased. In that case, patients can choose from 2 options: use the value of these unused treatments towards another treatment at our practice, or be refunded. This has been somewhat of a rare occurrence, but we’re just as happy as our patients when it does happen! This patient was refunded when her treatment didn’t take as many sessions as she had purchased.

PicoFractional laser skin rejuvenation is priced based on the area treated. For example, a larger area, such as full face rejuvenation, would be more expensive than a spot treatment, such as acne scars on the cheeks.

Why does having 4 wavelengths and adjustable spot size matter?

The industry standard (on nearly every laser available) is 1-2 wavelengths. A few have 3, like the new Smartlipo Triplex, but even 3 is pretty rare. The PiQo4 is the only one so far with 4. We could have bought all 4 wavelengths on separate lasers, but having these 4 wavelengths on this system, with it’s adjustable spot size, energy, and pulse durations (speed and pulse pattern settings) gives us these wavelengths in a far superior platform than other lasers offer. We had to bring in an electrician to specially wire our offices with enough power to fire this laser, and while our energy bills are high, the results are so amazing and worth it. Patients can expect up to 40% fewer treatments with the PiQo4 because of its unique spot size and high power settings – regardless of skin tone.

Ink Colors best removed by the PiQo4 laser at Reflections in NJThe Naturlase PiQo4 laser is an Nd:Y AG 1064 Q-Switched Laser with four wavelengths of light: 1064 nm (nanometers), 532nm, 650 nm, and 585 nm. This color wheel shows you the tattoo ink colors each wavelength is best at removing.

While it may seem like the 1064 wavelength doesn’t remove that many colors, it’s actually the wavelength we use the most, because nearly all tattoos have shading of some sort, which means there is some black or dark pigmented ink either mixed in with the other ink or laid deeper below it.

Getting rid of that dark ink first allows us to be more aggressive in treating the lighter tones because we can be confident that the dark ink isn’t going to be in there reacting negatively to the wavelengths that are needed to remove lighter inks. This is one of the more common reasons for complications we see from other offices. Because dark ink attracts light (laser energy) more readily, if you don’t remove it first (or you don’t realize it’s there and start by treating the lighter colors first), scarring can occur. Scarring on a tattoo is a big problem because once scar tissue encapsulates the ink, you’re going to have a very hard time removing it, and continued improper laser treatments will just create more scarring.

Here’s what each wavelength works best for:

  • 1064nm is ideal for removing black and dark blue tattoo inks and dark pigmented lesions on the skin, such as moles and seborrheic keratosis
  • 532 nm is ideal for removing red tattoo ink, pigmented lesions, and vascular lesions, including red acne scars, broken capillaries, etc.
  • 585 nm is ideal for removing sky blue and yellow tattoo inks, some of the more difficult to remove lighter tones of tattoo ink
  • 650 nm is ideal for removing both light and dark green and some tones of yellow tattoo inks

A larger spot size allows for deeper penetration into the skin’s layers and better treatment of pigment and ink.

Another perk of the system is the range of treatment sizes. The spot size of the laser treatment area is ranged from two millimeters to fifteen millimeters, which is a far wider range than other picosecond lasers, including PicoWay and PicoSure. In fact, the PiQo4 offers the largest uniform spot size available on any laser used for cosmetic treatments – almost 4 times larger than that of the closest competitor. Studies have shown that treatment with a larger spot size and lower fluence (one of the other adjustable settings on this laser) significantly decrease chances of adverse reactions.

Picoway vs. PicoSure vs. PiQo4 laser capabilities

Frequently Asked Questions about PiQo4


Medical Director at Reflections Center

Dr. Mitchell Chasin founded Reflections Center for skin & body as a place where physicians specializing in cosmetic medicine could focus on helping empower patients to feel their most beautiful. Dr. Chasin believes strongly that the best cosmetic physicians are those who are dedicated to mastering their craft through continuing education and collaboration with the industry’s top doctors.