We propose a new laser irradiation method for the treatment of cutaneous lesions in plastic surgery. In general, lasers with a spot size of 1 to 10 mm are used in irradiation on diseased skin. Although the target absorbs more light energy according to the theory of selective photothermolysis, the surrounding tissue, however, is still somewhat damaged. In proposed method, an f-theta lens, which is assembled by a shrink fitter, focuses the irradiation laser beam to a very fine spot with the size of 125 µm. Guided by the captured object-image, such laser beam is conducted by a pair of galvanometer-driven mirrors to irradiate only the desired tissue target without thermal damage to surrounding tissue. Moreover, an optical coherence tomography, whose probe is capable of wide field of view, can be used to provide the guidance information for the best treatment. The usefulness of the developed laser therapy apparatus was demonstrated by performing an experiment on the removal of tattoo pigment.