SACRAMENTO, Calif. — Let's say you are living in the moment, feeling giddy — a little tipsy, maybe — and you decide to go for it. You decide to get that tattoo.
Dr. Suzanne Kilmer has a warning for you: Think twice before acting. Not only do you face five times the risk of contracting hepatitis C, chances are you'll change your mind about whether you like your tattoo before you reach middle age.
Kilmer, 55, a clinical professor at the University of California-Davis, has seen tattoo-regret galore.
"Most people come in and say, 'It was something I did while I was young, and I've outgrown it,'" Kilmer said.
The founder of the Laser & Skin Surgery Center of Northern California, she's removed upward of 20,000 of the inky images.
That's no small accomplishment, and Kilmer is no ordinary dermatologist. It's something of a well-kept secret in Sacramento that in Kilmer the region has a world-renowned, pre-eminent expert in the field of laser tattoo removal and laser skin care.
To this day, Harvard University mentors who first worked with Kilmer as a fellow in the 1990s describe her as a pioneer in tattoo removal — and a force who has helped chart the future of the field.
"She actually had a hand in the very early development of lasers for tattoo removal," said Dr. R. Rox Anderson, professor of dermatology at Harvard University.
Kilmer also is known for creating a world-class laser center that does groundbreaking research for U.S. Food and Drug Administration clinical trials and as the only woman to have headed the American Society for Lasers in Surgery and Medicine.
But in the realm of tattoo removal, Kilmer's work has opened up possibilities for better and faster results — key in a nation filled with people obsessed with etching on their outermost organ.
Removal is difficult, lengthy and painful. Think hot bacon grease spattered on the skin. Think the sting of a stretched rubber band smacking you from up close. Imagine paying $150 to $1,000 for the multiple appointments to obliterate a tattoo.
People "have no idea how hard it is to get it off," Kilmer said of tattoo dye.
Among those who find themselves at her east Sacramento clinic are job seekers, career professionals and parents of young kids who seek to erase stigma, Kilmer said. There are former gang members and people with what's termed "traumatic tattoos" identifying them, for example, as former prisoners of war.
Brittany Costarella, 38, was in the laser chair one recent day, trying to rid her midriff of a winged, haloed red heart. It wasn't her first time there.
"Oh my gosh, if people knew how painful it is to get it off," Costarella said. "It feels like piercing hot oil. Not a hot oil droplet, but deep heat under the skin."
Lasers deliver hot, powerful pulses through the upper skin to a deeper layer where a tattoo artist has embedded pigment.
When the laser beam hits a particle of ink, its force fractures the pigment. Immune system cells then move in to clean up the mayhem, which the body's lymphatic system clears away.
One hopes, that is.
Some tattoos leave "ghosts" behind that simply will never disappear even after several rounds of the laser beam.
Melissa Leal, 30, a doctoral student in Native American studies at the University of California-Davis, was undergoing her ninth removal appointment one sunny April afternoon.
She had a silver nose ring, silver hoop earrings about the diameter of a soda can and a short bob of hair dyed as red as an apple. The tattoo on her ankle she didn't mind, but the swirl of blue-black curlicues on the back of her hand — that had to go.
As Leal was zapped, she looked away, grimaced and practiced deep breathing.
"What she's feeling is the heat breaking up the ink dye," Kilmer said. "Usually, if it hurts, it means it's working."
On this spring day with birdsong and blossoms in the air, an unusual sense of excitement charged the atmosphere inside the J Street complex.
About a dozen laser technology professionals crowded a hallway while awaiting the West Coast's first demonstration of a new, state-of-the-art picosecond machine.
That one-of-a-kind device delivers laser pulses at the rate of one-trillionth of a second, as opposed to a nanosecond machine, the industry standard, which pulses at the slower one-billionth of a second.
"This is just what I asked for," Kilmer said. "I've literally waited about 18 years for this. It took that long to figure out the science of sizing it down."
For her charity work in removing gang markings from the faces and necks of juveniles, Kilmer received several awards, including recognition in the mid-1990s from the Sacramento County Board of Supervisors as "Volunteer of the Year."
And even though it's been years since Kilmer erased that first tattoo, Cumings still exudes gratitude for her role in helping him shed his gang persona and lifestyle.
"The judge had said, 'The only way you'll get out of juvenile hall is to go see this lady and get that tattoo removed,'" recalled Cumings, who was taken to Kilmer in shackles.
As for the sting of the laser on his neck tattoo, Cumings' eyes watered.
"It's a little bit of pain," he said. "But these are tears of joy."
GET THE INK OUT
Who: Dr. Suzanne L. Kilmer
Information: Laser & Skin Surgery Center of Northern California, 3835 J. St., Sacramento
Contact: (916) 456-0400
©2013 The Sacramento Bee (Sacramento, Calif.)
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PHOTOS (from MCT Photo Service, 202-383-6099): TATTOO-REMOVAL