Nipple Tattooing: Restoring Self Esteem After Mastectomy

JulesBernstein on 14 Jan 2014 at 9:00am

nipple tattoo mary jane haake breast constructionMany women fear they'll never look the same after a mastectomy. But there are techniques that can help them feel whole again. Areola tattooing is one of these techniques -- which can re-create the three-dimensional look of a nipple.

We interviewed one of the few medical tattoo artists in the country whose work is covered by insurance companies. Meet Mary Jane Haake from Dermigraphics, in Portland, Oregon.

Why is medical tattooing one of your specialties?

My first areola tattoing client was in 1978, it used to be a year in between breast cancer clients. But, I also did cleft palate repairs. Very similar procedure. So, I got good at color matching.

That’s the challenge of nipple tattooing -- and it’s wholly unique to surgical scars and breast cancer. Sometimes you can’t get a perfect match, but you can get pretty close. I've worked on over 600 breast cancer patients over the last 3 years. 

How is nipple tattooing different than a decorative tattoo on your arm or leg?

nipple tattoo breast reconstruction mary jane haake

Medical pigments are different from traditional tattoo pigments. In traditional tattoos, the pigments are mixed with alcohol -- which evaporates and leaves a solid bright color behind. But, that’s 180 degrees from what we want for skin pigment matching.

In medical tattooing, we want to neutralize colors, making different shades of sandstone or brown. We might want [the color] watered down or even translucent. To achieve that, medical pigments have smaller molecules which makes them more easily implanted in the skin. And, to hydrate the pigments in medical tattoos, you use glycerin. Different hydrating fluids make different effects in the skin -- color mixing for skin matching is like watercolor mixing.

Are the pigments used in medical tattooing safe?

nipple tattoo mary jane haake breast construction

They’ve been tested for a long time, and allergic reactions are rare. They constitute less than 1-1000th of 1 percent. The pigments are very safe, as are the techniques.

How many sessions should be expected for an areola tattoo?

Every time you touch the skin [with a tattoo needle], you’re adding pigment. You can’t ever take it away. It’s all adding. The client's breast reconstruction -- whether it's tram flap, deep flap, grafted nipples or none at all -- determines your approach. You can’t do it in one appointment.

In my studio, it's usually 3 – 4 visits, 8 weeks apart. I do that so I can adjust the colors after it’s healed in. It may be a slower process for women of color who get hyperpigmentation and darker scars.

The tattooing is generally started a year or more after breast reconstruction - when the surgical scars are done healing.

What are women most worried about when they sit down for the first time?

nipple tattoo breast construction mary jane haake

[Women with breast cancer] are a bit of fatigued by the time they get to me. They’re soldiers in a war and they want out. When they come in they're apprehensive -- many don’t have any experience with tattoos. Some think I might pop their implant – that’s not a real concern. I only deal with the dermis. My needle goes an 84th of an inch into the skin.  

A lot of my job is just to get them comfortable with the process. People want to look in a mirror and see their authentic self again. And it’s my job to help them get there.