The author of this tutorial is Tammy Russotto. She writes that the AKVIS programs make editing so much quicker and easier. It's even more fun. Make sure to practice and in no time you will be zipping through your edits with no problem.
In this case the author wanted to make a portrait to be used to send to family and she decided to remove the tattoos. The model in the image is Tammy's 25 year old daughter, Tiffany.
Please follow these steps:
Step 1. Open image in your editing program by the command File -> Open.
Original photo of a daughter
Step 2. Using the Rectangular Marquee tool select the areas to be retouched.
Select the tattoos
Step 3. Then call up the AKVIS Retoucher plugin: Filter -> AKVIS -> Retoucher.
The selected area will be displayed with a transparent red color.
Selected area displayed with a red color
Step 4. Click on to begin the retouching process and you can watch as the selected area is removed.
Step 5. When it's done click on to save it and return to editing program. If there are other areas that need to be retouched repeat the above instructions.
Step 6. Now call up the AKVIS SmartMask program by the command Filter -> AKVIS -> SmartMask.
There are three modes tailored to different selection types. Choose Sharp. Using the Keep Area Pencil go just inside the part of the image you want to keep. Then using the Drop Area Pencil outline the area you want to get rid of.
Draw contours
Click on the arrow button to process the image.
Step 7. Now choose the Soft mode. Using the slider for Green Zone Width make the green area the width between the blue pencil and the red pencil. Then click on to have a clear background.
Color zones
Step 8. Just above the image you will see 6 little squares - the view modes.
Click on the button Show Color Background to open the dialog Select Color and choose new background color. If you don't want to add your new background yet or are done click on the checkmark button to save and return to your editing program.
Step 9. Open AKVIS ArtSuite plug-in to add a frame: Filter -> AKVIS -> ArtSuite.
In this tutorial the author has chosen the Artistic Frame in white. The frame width was changed so that it will fit the image.
Choose a frame
Step 10. Once you have achieved the frame you want, click on the checkmark button to apply the frame to the image and return to editing program. If you feel there are any tweeks to be made go ahead and do it and then save a beautiful new image.
select the areas to be retouched.
to begin the retouching process and you can watch as the selected area is removed.
to save it and return to editing program. If there are other areas that need to be retouched repeat the above instructions.
go just inside the part of the image you want to keep. Then using the Drop Area Pencil 
outline the area you want to get rid of.
to process the image.
to open the dialog Select Color and choose new background color. If you don't want to add your new background yet or are done click on the checkmark button to save and return to your editing program.
— Removing Tattoos