Frank Charles, a pet-resort owner and former five-term mayor of St. Augustine, Florida, wanted a tattoo. He just wasn’t sure that he could take the pain. Then he started seeing advertisements for a place in Miami called Sedation Ink, which offers clients the attention of its licensed anesthesiologists. “You’ll enjoy a deep and peaceful sleep, allowing our artists to create breathtaking designs on your skin,” the studio’s website reads. “Join us and experience the future of tattooing, where pain is eliminated, and dreams become reality.”Charles is no stranger to elective anesthesia, he told me. He’d gone under in the past for a nose job, a chin-reconstruction surgery, and hair transplants (twice). So the idea of being inked up while unconscious didn’t bother him at all. As for the actual experience, well, it’s hard to say. In photos of the operation, his face is covered with a dark and heavy cloth. (He looks a little bit like someone being waterboarded.) The only thing he can remember is a vision that he had while on the table. “I dreamed of waking up,” he said, “and the tattoo was in the wrong location.” It was not: Eight hours and $29,000 later, Charles came back to his senses with a picture of a blue-eyed, bejeweled lion on his right pectoral, which morphed into an American flag and then a bald eagle along his forearm (also part of this tattoo: the Statue of Liberty and the preamble of the U.S. Constitution).This design may now belong to Charles and Charles alone, but the way that he received it—fully zonked on fentanyl and propofol—has been gaining popularity, especially among the young and rich. Two years ago, the Dallas Cowboys quarterback Dak Prescott went under for almost half a day, during which time multiple artists worked together on producing a full leg sleeve depicting, among other things, a Pegasus, a moose, the Dallas skyline, and a firm handshake. More athletes followed, getting very large tattoos that would otherwise have needed to be created across multiple sessions in a parlor, with bouts of healing in between—an arduous process that can take many weeks to complete. Even the singer Post Malone, one of pop culture’s most conspicuously tattooed celebrities, has gotten work done while medically unconscious.To a certain type of person, the appeal of these procedures is self-evident: Getting a needle jabbed into your skin hurts. But for another type of person—one who feels personally, professionally, or even ideologically invested in the culture and traditions of tattooing—this trend will be unnerving. Blasphemous, even.Getting tattooed is a way of “teaching you something about what you’re capable of,” Don Ritson, an artist based in Winnipeg, Canada, told me. “In this postmodern world where we don’t have these same feats of strength, it gives us an opportunity to prove to ourselves that we’re capable on some level.” As someone with a few dozen tattoos, each of which was at least a little painful to receive, I appreciate that argument. But I also balk at the idea that having a doodle dug into your body is a measure of your prowess. I don’t think anyone would take a look at my tattoo referencing a joke from the sitcom Frasier and think, Wow. What a strong guy. I wonder what feats of strength he’s capable of? Even the outward projection of physical strength—something I also value, and work to maintain with waffling levels of commitment—seems preposterous in a world of pricey gyms and personal trainers.For Ritson, who delivered a recent TEDx Talk called “Marked Without Feeling: What Tattooing Loses Under Anesthesia,” the experience of pain is a stamp of one’s personal resolve, and without it, tattooing risks losing whatever remaining connections it has to various underground subcultures. The anesthetized tattoo is “tied to these athletes or actors, people who have money, but they don’t have time,” he told me. “They kind of want to skip the line a little bit. They want the thing, but they can’t actually commit to doing what it takes to get the thing.”Tattoo culture has in many other ways been normalized and gentrified over the past few decades. Once the province of bikers and sailors and scumbags, tattoos now appear on nearly one-third of all Americans. Modern shops look less like punk bars than pricey hair salons or smartphone showrooms. But tattoos like Frank Charles’s, produced in an operating theater at much higher cost, would seem to be the culmination of this trend. If a standard tattoo parlor might refuse service only when a customer is clearly underage or way too drunk, or both at once, the people who come into Sedation Ink in Miami are screened as if they’re getting rhinoplasty or some other cosmetic procedure. They need “a full medical clearance from a physician,” Noel Pace, a health-care attorney who works with the studio, told me. “It’s like going into a surgery.” Indeed, Sedation’s customers are described not as clients but as “patients.”For “Sweet” Dave O’Connor, a tattoo artist in Hamilton, Ontario, who has done a number of my tattoos, the transformation of a parlor into a medical clinic negates its social meaning. O’Connor works in what’s called the “traditional” style, characterized by bold outlines, a crisp color palette, and familiar tattoo-shop imagery: anchors and horseshoes and vipers and clipper ships and jaguar heads and whatnot. His thinking about the enterprise is similarly old-school. The move toward tattooing under anesthesia is “the complete end-game of the ‘Customer is always right’ attitude,” he told me. “The one common thread through every tattoo, regardless of the size, shape, style, the person getting it, is that there’s pain involved. It’s the one thing that unifies all tattoos. And if you take that out of it, then what is there? You didn’t do anything for it. Other than pay for it. And take a nap.”[Read: The new meaning of tattoos]Other tattooers aren’t quite so ruffled by the practice. The L.A.-based artist Romeo Lacoste has tattooed celebrities including Kendrick Lamar, Ariana Grande, and Justin Bieber. He has tattooed backstage at concerts. He has even tattooed on a private jet. He told me that he regards tattooing in a surgical room with the aid of anesthetic as just another step in the evolution of his art. There are practical benefits too. Without sensitive patients squirming under the buzz of the needle, he said, he’s able to get cleaner work done more efficiently. He also enjoys collaborating with other artists on a single, large piece of art. “A lot of those guys want to complain now,” he told me, but their fixation on the old way of doing things will soon be left behind. “The mentality that you have to earn your pain is just going to get more watered down. Eventually, I don’t even think that mentality will exist anymore.”At the very least, that mentality will face commercial pressure to adapt. In July, shortly after the heavy-metal singer Ozzy Osbourne’s passing, I went into a small tattoo shop around the corner from my house. Since I was a teenager, I’ve told myself that I’d get a tattoo of his name when he died. Hellbent on making good on the dopey promise of my younger self, I forked over $50 to have the letters OZZY inked onto my forearm. During the (very brief) session, I asked the artist what he thought about the entry of anesthetics into tattoo culture. He said he had compunctions—in theory. But he also copped to the fact that he’d be glad to take the daily rate of $10,000 that one gets to do that kind of work.[Read: Tattoos do odd things to the immune system]The allure—for artists and their clients alike—is clear enough, even if the new approach carries certain hazards. Earlier this year, a 45-year-old Brazilian social-media star named Ricardo Godoi went into a private hospital for a full-back tattoo while sedated and intubated. Near the start of the procedure, he went into cardiac arrest and died. Although dozens of cases of death from anesthesia are recorded every year in the U.S., the risk to any individual is very low: Fewer than one anesthesia-related mortality occurs for every 100,000 procedures, according to a 2018 study. And the notable tattoo parlors that offer this procedure—Sedation Ink, as well as The California Dream Tattoo and Ganga Tattoo in Los Angeles—tend to operate more like medical centers than studios. At some studios, artists dress in surgical scrubs and are overseen by a board-certified anesthesiologist.But maybe even just that teeny-tiny chance of death can make the anesthetized tattoo a test of mettle, too, in the way that Ritson meant: The added risk becomes a counterbalance for the loss of pain, on some kind of toughness scale. Or perhaps the rise of sedation-assisted tattoos will serve to raise the floor for every other form of body art, no matter how routine, if it comes without the benefit of propofol. Sure, you may have gotten a pencil-thin etch of a wheat sheaf inked into your arm at a shop that looks like an Apple store. But at least you were there. At least it felt like something. At least it hurt.