Hello and thank you for your question and providing a photo. Our practice has been using the PicoSure laser since it received FDA approval for tattoo removal over three years ago. The way that the PicoSure laser works, is, if you think of the ink of a tattoo as a "boulder", other lasers break the ink into "rocks", the PicoSure laser shatters the ink into "grains of sand". These tiny particles are then eliminated by your body over time.As a medical practice, we follow traditional clinical protocols, and we recommend that you find a highly experienced practitioner that does the same. They should start with a free consultation, take information from you to determine if you are a medically appropriate candidate for laser treatments, and take specific measurements to determine the size of the inked area (versus drawing a frame around the tattoo). Pricing is determined primarily by the size of the tattoo. Finally, the clinician should work with you to create a treatment plan to estimate the number of treatments they anticipate will be required, cost per treatment, and the timing. Most tattoos take between 6-8 treatments, and treatments must be spaced at least 8 weeks apart to allow your body the time it needs to clear the shattered ink.Your tattoo appears to be very densely inked, with a red star. The "sunset colors" (red/yellow/orange/pink) are some of the most difficult to remove, so be sure that the practitioner that you choose has the special laser attachments to specifically treat the red.It is impossible for anyone to guarantee perfect removal-the known entity is the quality of the laser used and the skill of the clinician-the unknown is the type of ink used and how well it will respond to treatment, as well as your body's own ability to assist in the process after the laser has done its' job. However, finding a clinician with significant training and experience with similar (in density, size and ink color) tattoo removal will increase your chances of satisfactory results. I would expect that it would be reasonable to expect significant results, it will just take time and patience.All the best to you!