Nicole Payne unzipped her black leather ankle boot and revealed an image she came to find so loathsome and ugly she usually kept it covered.
It is a likeness of a bottle-nosed dolphin, measuring about 3 inches by 1-inch, tattooed in blue-black ink on the inside of her right ankle. "It is just disgusting, just gross," said Payne, 27, gazing at the tattoo.
Minutes later, Dr. Thomas Chu switched on a double YAG laser and began the first of the three or four treatments she likely will need to erase the dolphin. The entire process probably will take six to eight months.
Chu offers tattoo removal as part of his dermatological surgery practice.
Thanks to the convergence of pop culture and technology, business is booming.
In the past 25 years, tattoo professionals have watched their art form move from the fringe to the American mainstream. Now along with sailors, bikers and convicts, college students, athletes, musicians and white-collar professionals flash tattoos on their ankles and biceps and around their navels.
Dennis Dwyer, executive director of the Alliance of Professional Tattooists, estimated 10 percent to 20 percent of Americans now sport a tattoo. But his estimate came with a caveat: "It is still a somewhat secretive culture."
Where once the only removal options left behind scars as large as the unwanted tattoo, the past decade has seen the introduction of lasers specifically for tattoo removal. They use wavelengths that are absorbed by certain tattoo inks, but not the surrounding skin. The laser energy breaks the ink into smaller pieces, which gradually are removed by the body's scavenger system. Removing a professional tattoo typically takes four to six treatments six to eight weeks apart.
For patients like Payne, an administrative assistant at Financial Institution Consulting Corp. in Memphis, that typically means no scar and no tattoo.
Dr. Michael Bond, who is certified in dermatology and pediatrics, said not everyone is so lucky.
Greens, yellows, turquoise and other vibrant ink colors aren't as sensitive to the laser as blue, black and red ink are. "There may be some residual ink that doesn't come out or a ghost-like image, but it is usually much better than the tattoo itself," he said.
Permanent makeup can also be difficult to remove, Bond said. Rather than fading, the laser sometimes triggers a color change that will linger for months until removal is complete.
"I don't do lip liner," he said, "You don't know what mountain you are going to have to climb when you do the first (removal) treatment. You can end up with a black line around your lip, and that's not good."
Bond said it is not unusual to treat individuals who want their tattoos removed almost as soon as the ink has dried. "Tattoos are wonderful, but people change, and we aren't used to having things that are permanent. If tattoos faded in a couple of years, I think 90 percent of the country would have one," he said.
Payne's disenchantment took a bit longer. As a teenager, she thought tattoos were cool and looked forward to getting one. "It seemed like it was the thing to do," she said.
She was 20 when she and a friend stopped at a tattoo shop. She walked out with a dolphin on her ankle. Although her mother was unhappy from the first, Payne said it didn't bother her until several years later.
Payne decided it sent the wrong message. It was making her so self-conscious that she started covering it with a bandage when she wore shorts or a skirt. "I try to hide it if at all possible," she said.
The discomfort finally brought her to Chu's office.
The removal procedure lasted less than a minute.
Both doctor and patient donned protected eyewear.
Then Chu switched on the laser and moved the beam over the dolphin image buried in the second layer of Payne's skin. There was a sharp popping sound, and her skin swelled slightly as he traced the image.
Treatment complete, he swabbed the site with antibiotic ointment and covered it with a piece of gauze held in place by an elastic bandage.
When the skin anesthetic wore off, Chu said the area would sting like a bad sunburn and the area would likely swell.
Payne was sent home with Chu's advice to skip exercise that night to reduce swelling. She was also advised to keep the area moist and covered while it healed.
Chu said the tattoo should be noticeably lighter after a single treatment. Payne said she hopes it will fade enough by summer that she will be back to wearing shorts without a bandage.