Women who choose to complete reconstruction with tattoos have multiple options—areola only, 3D nipple/areola, or decorative/picture tattoos. So where to get a breast reconstruction tattoo? Some women choose to have tattoos performed in their plastic surgeon’s office (if a medical tattoo artist is on staff), while others choose a private tattoo artist.
And now, the rest of the story: the tattoo artists. Thanks to my interviews with other breast cancer survivors and mastectomy patients, I was able to be thoughtful about my questions for the two tattoo artists I interviewed (I was only able to listen to the podcast of one interview due to the snow and cold we have enjoyed this winter, and the second I was able to speak to directly).
Trent, Private Tattoo Artist
Trent, a private tattoo artist, has been focused on tattoos for mastectomy patients for 4 years, tattooing over 1300 women and several men. He starts out with a full interview of the survivor, complete with medical /surgical history and healing qualities, such as any difficulties with the incision site, infections, etc. He understands the damage caused by radiation in terms of skin thinning, darkening and tissues resistance to colors. A general rule is to err on the side of caution and therefore, Trent suggests a minimum of six months—he prefers 12 months—of healing prior to receiving a tattoo.
Trent’s interview process with survivors lasts about an hour. After getting to know the survivor, their likes and hopes as well as any fears they may have, Trent investigates the breast reconstruction and together, Trent and the survivor determine nipple placement, which can be based on the incision pattern or scars and the location of the implant. A discussion of what is available for individualization can then begin. Photos and ideas in advance are very helpful! He noted that aside from areolas, the most common requests are decorative flowers, leaves, swirls and a lot of inspirational quotes and meaningful words.
As we discovered in the first blog, tattoos are basically pigment that is injected with fine needles into the skin which is then surrounded by collagen. In the first year with your tattoo, your lymphatic system encapsulates the pigment into your skin, which can look like fading. To ensure proper coloring, Trent will do swatches of color on the skin to see if he can achieve the look desired and to make sure the pigment doesn’t react unfavorably to the skin.
A simple nipple tattoo can take anywhere from 15-20 minutes per side. With the interview and placement, it can be a 2-hour process. A picture or decorative tattoo, depending on the size and intricacies of the design, may require additional visits and time. As a quick reminder, tattoos are intended to disguise or detract from the scar only. Careful explanation and time with the artist will highlight that a tattoo cannot change the color or texture of the scar.
Susan, In-Clinic Tattoo Artist
My second interview was with Susan, a medical tattoo artist who performs tattoos for survivors in a plastic surgeon’s clinic. Susan meets with survivors in their clinic for a 45-minute consultation specifically for tattooing the areola. Like Trent, Susan begins with an intake interview that includes the status of the skin and any nipple reconstruction. She had interesting observations about the differences in generational desires to tattoo. Not so surprising, the younger survivors are more inclined to immediately push on to get their tattoos where survivors over the age of 50 tend to be more patient or even choose not to go through the tattoo process.
Of all the patients/survivors Susan has tattooed, none have regretted it and many have mentioned to her that having the tattoos makes them feel normal again. Susan suggested investigating your tattoo artist for their specific experience in this area. Not unlike your surgeon, you want to have both capability and chemistry in the person permanently tattooing your chest. Susan also mentioned contacting your insurance company to make sure they will pay for the tattoo. Nipple tattoos in-clinic require 2 visits: the first for intake and tattoo and the second for follow-up care.
Now fully informed, having completed my interviews with both a full-time tattoo artist and a medical tattoo artist, what do I do? I would like to be definitive and say I am all in and I have selected a design (yes, I did choose a design over nipple/areola!), but I think I will look at the zipper just a little longer. I am convinced something has to be done, but do I want the Forget-Me-Not flowers or a quote?? So to tattoo or not to tattoo, is no longer a question now the question is who, when and where? Until then, I hope this has been enlightening and if you would like to know what October brings, stay tuned.
Linda is a 2 year survivor of triple positive breast cancer. She is a full time medical writer and resides in Maple Grove.