Every year, thousands of women in the U.S. who are faced with a breast cancer diagnosis have to make the difficult decision to undergo some form of mastectomy, or the partial or complete removal of one or both breasts. Some women have the disease and opt to have the surgery. Other women (like Angelina Jolie) who are carriers of the BRCA1 or BCRA2 gene mutations, hope that removal of healthy breast tissue will save them from a cancer scare down the road.
In some cases, this surgery can be life-saving and a huge relief. But that often doesn't negate the emotionally trying process of losing a part of one's body or accepting new scars. Many women seek a variety of cosmetic solutions to move through these challenging experiences. And one of those solutions is getting a mastectomy tattoo.
If you're curious about getting one or wondering whether they are for you, here's all you need to know, according to medical and artistic specialists.
First, what is a mastectomy tattoo?
A mastectomy tattoo is a tattoo that's designed to cover up scars from breast removal surgery.
Oftentimes, these are simple areola tattoos, according to Jonathan Bank, M.D., a board-certified plastic surgeon at NYBRA Plastic Surgery. When surgeons cannot spare the nipple during a mastectomy, they can often reconstruct breast (if the patient desires) then either instruct a technician or a pro tattooist to ink on a realistic-looking nipple to make things look like the breast hadn't had a major operation.
"It really gives a natural appearance and transforms [the reconstructed breast mound] from something that just fills a bra to something that has the full picture," says Dr. Bank.
Some women, though, choose to get tattoos that are more colorful and decorative — at times, designs that span the whole chest. Intricate flowers, lace, feathers ... the possibilities expand as far as the imagination can stretch. Of course, these beautiful creations are done by professional tattoo artists.
One thing to note, though: Whether it's a regular areola tattoo or something more elaborate, there are many types of people besides mastectomy patients who opt for this sort of body art, says Shaughnessy Otsuji, a restorative tattoo artist and owner of Studio Sashiko.
"I see a lot of women who've had [general breast] reconstruction — like a lift or any sort of reduction — trans and non-binary clients who've had top surgery, and some people who've had scarring from an intense accident or disease that can remove the pigment and cause a lot of kind of disfiguration in the area," she says. "So any person who for any reason wants scar coverage or re-pigmentation in that area can have a tattoo done."
Are there any health risks in getting a mastectomy tattoo?
Fortunately, getting a tattoo is a very low-risk endeavor health-wise, according to Stacie Rae Weir the founder of A.R.T. School, which trains tattoo artists to work with breast cancer survivors.
"A tattoo is a really superficial kind of wound," says Weir, who is also a breast cancer survivor with her own badass mastectomy tattoo. "We don't even go through half of the layers of skin so it's fairly non-invasive."
Professionally licensed tattoo artists (and medical professionals trained in tattooing) use single-use sterile needles and other hygienic practices to keep you as safe as possible. (If you have any doubts about the shop or equipment, it's best to leave and do more research). But because they are penetrating the skin with a needle, there's always a chance that the area can get infected like with any old scratch.
The risk is higher if a person is on medication like blood-thinners, adds Weir, which can disrupt the healing process and make your skin more vulnerable to bacterial infections. So, make sure inform your artist about any medications or conditions that may be of concern; and always follow the tattoo aftercare guidance you're given to allow everything to heal properly, says Dr. Bank.
If you're wondering about the safety ink itself, ask your surgeon or tattoo artist about which ink they use. Generally, the pigment used in well-run parlors and doctor's offices are safe to use, says Weir. But if you're curious about the amount of heavy metals or the safety of any of the ingredients, you can always lookup the ink's Safety Data Sheet for clarity and peace of mind.
How long after surgery should I wait before getting a mastectomy tattoo?
Allowing your skin to heal properly before you jump to get a tattoo is not only key to keeping you healthy, but also to help your tattoo look as beautiful as possible, according to Dr. Bank. That healing time can vary greatly depending on how many operations you had and if you received radiation or chemotherapy treatments.
"Usually, we like to wait at least three months to six month," says Dr. Bank. "Although, I would always caution on the side of safety and wait longer, especially when you're going to someone who's not directly in the medical field."
Weir finds, though, that sometimes even surgeons can give their patients the okay too soon. "Once the scars are white, they are ready to be tattooed,'" she says. "If they are still red, you can make the scarring worse."
When in doubt, it's best to consult your physician and a trusted artist who's done extensive work with mastectomy patients to make sure you settle on a timeline that's best for your body.
Who should I go see to get a mastectomy tattoo?
If it's not obvious already, you don't just want to hop over to the parlor down the street to get a mastectomy tattoo. Tattooing skin that's undergone surgery and other treatments like radiation and chemo is a whole other ball game, according to Otsuji.
"Since surgeons remove so much tissue, the skin tends to get a lot thinner," she says. "Radiation can also make the skin coarse and tough on the outside. So for me, as an artist, I have to analyze each breast accordingly. The goal is never to overwork the skin because you don't want to cause more scarring and trauma to the area."
What's more, "drawing a nipple is one thing while tattooing it is another thing," adds Weir. "So you do have to seek out somebody who really understands the artistic, optical illusion side of it and the scar tissue side of it."
Artists also have to work with the unique contours of your body. "We have to take the muscle flow of the body and the body mechanics into consideration to design something that's flattering," says Weir. "You don't want to plunk something over the scar itself, which tends to exaggerate it. You design to the body so you don't notice the scar."
Overall, you really need an experienced pro to do your tat — even for "simpler" areola designs. Be aware that not all plastic surgery teams have skilled artists. Otsuji, for example, has seen many clients who've needed to rework or cover up their areola tattoos done by medical staff. So, it doesn't matter if it's a medical technician or an artist who's been tattooing for years. Ask to see a portfolio and see if you like the person's work before you have them inking something permanent into your skin.
Not sure where to find an artist? Your surgeon may be able to point you to someone who does great work. Dr. Bank, for example, has worked with Nicole Rizzuto, a talented medical tattoo artist. Otherwise, you can reach out to nonprofits, like Personal Ink, that connect breast cancer survivors with tattoo artists that specialize in mastectomy tattoos in your area.
Mastectomy Tattoo Ideas
When working with the right artist, you can surely create a unique and gorgeous design that speaks to you and your journey. This realm of body art is ripe with all sorts of possibilities. For some inspiration, scroll through the alluring examples below:
Bird and monarch butterfly tattoo by Shane Wallin
Peacock feather tattoo by Samantha Rae
Blooming trees tattoo by Delshay Haaheo
Rose tattoo by Stacie-Rae
Unique design by Justin Wild of All Sacred
Oak Tree and red rock tattoo by Shane Wallin
Deer tattoo by Bill Folk in partnership with Personal Ink
Mastectomy tattoos are a relatively safe and beautiful form of art that can help a person embrace their body post-surgery, according to Weir. She can't tell you how many clients she's seen leave her parlor with happy tears in their eyes.
"I think a lot of people, myself included, don't realize how good you can feel about yourself after you get the tattoo," she says. "When I got it, I had this totally different attitude towards myself and this pep in my step. I never realized I could love my body that much."