hi, that a fair amount of work.... your going to be doing a lot of going back and forth
but i think how it might work out... is using your patch and healing brush on the lettering and get replaced nicely... and you may need to use the clone brush a little if you lose too much texture... the pictorial tatoo...mmm i would maybe go with doing a copy and pastedof a good section and then move it over on top of the designe and use a low opacity brush to trim the edges ....
there no set steps to follow a lot of it is going back and forth adjusting opacities and little experimenting before you get it just right...