Choosing to get a tattoo can involve a lot of questions: What kind of design? Where should I put it? How big? Will it hurt?
These decisions can be made painstakingly, or they can be made under the influence - of friends, or perhaps alcohol. They can also be made in the name of love.
The thing about tattoos, however, is that they are permanent. Or they were.
Dr. Zachary Veres uses a laser tattoo removal tool on Jason Tusinac of Poland March 27 at the Vayda Cosmetic Laser Center on Mahoning Avenue in Warren. Light from the laser casts a green glow in the room.
On a recent Friday in March, Danielle Hall of Warren was at the Vayda Cosmetic Laser Center in Warren receiving treatment to remove a tattoo of a ladybug from her chest.
Hall said she was persuaded to get inked at age 17, and now she feels that "tats are tacky."
"I'm in a lot of weddings," said the 24-year-old bartender. "I wanted it removed for a long time but finally got the guts to do it."
New technology is allowing for much easier removal of unwanted body art.
According to TAT Be Gone Web laser tattoo removal site, tattoos can be removed by directing laser energy at the area for a fraction of a second. The energy passes through the outer layer of the skin and targets the tattoo ink directly. The ink is disrupted, which allows the body to absorb it and break it down.
"Your body's natural immune system gets rid of it," explained Dr. Zachary Veres of the Vayda center, which offers TAT Be Gone.
He said certain colors react differently: Red ink is superficial and fades quickly; black is deep; and blue is deeper, taking the longest to disappear.
"If you live long enough, white will go away," said Veres, who traveled to Las Vegas to learn about new laser techniques.
The center sees about 15 people a week for tattoo removal, although sometimes they can see up to seven a day, and Veres said people have come from Kentucky, West Virginia and three hours into Pennsylvania.
Removal takes several treatments, depending on the size of the tattoo, with four- to six-week breaks in between each session. The cost, according to the Web site, is about $39 per square inch for pay-as-you-go treatment, and package deals are available.
Other northeast Ohio facilities offering laser tattoo removal are Ohio Valley Plastic Surgery in Cuyahoga Falls and Aesthetic Lasers & Cosmetic Rejuvenation Center in Beachwood. There are also options in cities such as Cleveland, Columbus, Dayton and Cincinnati.
Veres is currently seeing a client with a full back tattoo featuring the scales of justice and "a bunch of words" on top. The tattoo is about 75 percent gone.
Veres said most of his patients just don't like their tattoos anymore, or have realized it was a mistake.
Another option for those with undesirable body art is to cover it up with another tattoo.
Sean Willis of Asylum Tattoos in Cortland said he has one to two people coming in each week for coverups, especially those with tattoos of names.
Willis said he always advises his clients not to get names tattooed on their bodies.
"Especially if they're young," he said Thursday, "I tell them it's a bad omen."
Willis, whose shop has been open for about three years, says common candidates for coverups include homemade tattoos, as well as older ones. In addition to the names, he has inked over designs such as marijuana leaves and gang signs.
In fact, among the earmarks in the $400 billion American Recovery and Reinvestment Act is a "tattoo removal violence outreach program" in Los Angeles.
According to an Associated Press report quoted on tattoohealth.org, Rep. Howard Berman, D-Calif., "secured $200,000 for a tattoo removal machine that could help gang members or others shed visible signs of their past, and anyone benefiting would be required to perform community service."
Willis said a lot of sailors also have certain depictions they want to be covered, and sometimes people just let the sun fade their tattoo.
"It's a way to get a new tattoo without having too many," Willis said.
Jason Tusinac of Poland, who was at the Vayda center March 27, is having a Grim Reaper design removed from his upper arm. He got the same tattoo as some friends when he was about 20 years old. He said he liked it for a few years.
"I don't want it anymore," said Tusinac. He hasn't seen those friends for a while.
Tusinac, now 31 and married, has three children who he doesn't want getting tattoos when they get older.
According to an article on Web MD reviewed by doctors at the The Cleveland Clinic Department of Dermatology, because of newer technology, laser tattoo removal has become much more effective with very little risk of scarring.
Patients at the center are sent home with detailed directions for follow-up care.
A question naturally comes up with removal as it did when deciding to get the tattoo: Will it hurt?
Veres used a topical anesthetic on Hall, and there is a skin cooling unit that directs soothing cold air onto the area before, during and after treatment.
Hall, who also has a different design on her lower back, said it hurts more to get a tattoo.
Tusinac said his first laser treatment felt about the same as getting the tattoo.