As Breast Cancer Awareness Month winds down, we wanted to talk about one of the last steps some of our breast reconstruction patients face: nipple reconstruction and tattooing.
Once the breast reconstruction(s) are complete, nipple reconstruction can take place several months after breast surgery and following other treatments. Patients may elect to undergo nipple reconstruction on one or both breasts using local flaps, grafts, or a combination of the two. After the reconstructed nipple has healed, nipple tattooing can re-pigment the area, to make it look more realistic.
Nipple tattooing, as I've come to find out, is a true demonstration of art's impact on healing.
We're very fortunate at Penn to have a skilled tattoo artist who specializes in 3D nipple tattoos along with tattoos for scar camouflage or cosmetic purposes - Mandy Sauler, a micropigmentation specialist in Penn's Plastic Surgery Division.
Mandy never imagined she'd find herself working as a tattoo artist in the most unlikely of places, a hospital. Her mother owns a body art shop outside Philadelphia, so Mandy grew up expecting to build a career working and teaching tattooing in her mother's shop. After spending nearly a decade as a full time tattoo artist, Mandy explored the burgeoning area of permanent cosmetics, and trained with an expert in micropigmentation, where permanent pigment is placed below the dermal layers of the skin. She earned her board certifications through the American Academy of Micropigmentation, is a member of the Society of Permanent Cosmetics and is now a busy permanent cosmetics/tattooing expert.
I asked Mandy for some tips and things to consider when investigating whether nipple tattooing is a good option. Here are some of her tips.
- Procedures are done on the same day, so come prepared to talk about color, size, and scars, to make sure the tattooing complements your skin and looks good.
- Pigments can be matched to your natural shades. For some, it's been a year or two since the initial breast surgery. When it comes time for the tattooing, it's a great idea to bring photos from before the surgeries began, if you have any. For women who have had a single mastectomy, tattoo experts can try to match the pigment to your natural colors. For some, it takes 1-2 sessions before pigment fully absorbs, so it doesn't fade over time.
- Artistic ability is key. To get the proper color, shading, and realistic look, you need a true tattoo artist. Look for an expert who has a lot of experience, board certification, and proper licensure for your state. Pennsylvania has no regulations, New Jersey requires board certification, and in New York, a tattoo license is required. And don't be afraid to check their references.
- Just like any tattoo, aftercare is important, so follow the instructions you receive.
If you wind up going to the hospital to get a tattoo, you're not the only person to be surprised by the intersection of art and medicine.
"I accepted the fact that I'd be a body artist working in my mother's shop for the rest of my life, and now I walk through a hospital to get to work, " Mandy told me. "My craft has taken me in a completely different direction. It's amazing to see the emotional impact a tattoo can have on a person's life."