In a saucepan, combine the milk, heavy cream, and sugar. Heat over medium heat, stirring constantly, until the sugar is completely dissolved. Do not bring to a boil.
Remove the saucepan from the heat and stir in the tahini and vanilla extract. Mix well until the tahini is fully incorporated and the mixture is smooth.
Let the mixture cool completely to room temperature, then refrigerate for at least 2 hours, or preferably longer, until thoroughly chilled.
Pour the chilled ice cream base into an ice cream maker and churn according to the manufacturer's instructions. If you don't have an ice cream maker, pour the mixture into a freezer-safe container and stir with a fork every hour to break up ice crystals.
Transfer the ice cream to the freezer and freeze for at least 4 hours, or until firm.
Before serving, let the ice cream sit at room temperature for a few minutes to soften slightly. Garnish with toasted sesame seeds or a drizzle of tahini.
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