Tattooing is increasingly common in Western society. The aim of the study was to create an overview of the surgical options when a tattoo is present in the operative site and to present an algorithm for the surgical plan.A literature-based study was conducted, using the Pubmed database. The following search terms have been used: "tattoo" in combination with "incision," "scar," and "surgery." Apart from the literature, we also used our own clinical experience with the tattoos.An overview is presented on the different options when a tattoo is at risk because of a surgical intervention. An algorithm is presented to help surgeons to choose the best option before the operation.By realizing that a tattoo can be of great value to a patient and by using surgical skills to preserve the tattoo as much as possible, it becomes possible to increase patient satisfaction in these difficult cases.
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