Don Ed Hardy, who had trained in fine art and then spent time in Japan studying under tattoo master Horihide, opened Realistic Tattoo in San Francisco in 1974 and proceeded to transform American tattooing by introducing Japanese compositional principles, painterly technique, and a fine-arts intellectual framework. Hardy insisted that tattooing was a legitimate fine art form, exhibited tattoo flash and drawings in galleries, published extensively, and built an international reputation that attracted collectors who treated their bodies as canvases. His influence on the professionalisation and aestheticisation of tattooing in the late twentieth century was unparalleled.

Hardy's insistence on tattooing as fine art contributed to the critical discourse that repositioned body modification within the broader art world debates of the 1970s and 1980s — debates that also encompassed conceptual art, body art (Burden, Acconci), and performance poetry. His integration of Japanese aesthetics into American tattooing reinforced the influence of Japanese visual culture on American poetry and visual poetics that ran from Pound's Imagism through Gary Snyder's Zen-inflected verse. Hardy's own writings on tattoo culture provided important intellectual framing for literary treatments of the tattooed body as aesthetic object.