Tattoos After Mastectomy
Some people opt for a decorative tattoo on their breast or chest following breast cancer surgery. This is known as a "mastectomy tattoo" but can also be done after other types of breast surgeries, like breast-conserving surgery or reconstruction.
Nipple and Areola Tattoo
Nipple and areola tattoos differ from decoratioosve tattoos, as they focus on creating a natural-looking nipple on the skin. These tattoos are typically done by a specially trained doctor or nurse, though some tattoo artists also specialize in this type of tattooing. For more information, you can speak to your treatment team or refer to resources on nipple and areola tattooing.
Tattoos to Cover a Scar
You might consider getting a decorative tattoo after breast cancer treatment to boost your confidence, symbolize what you've been through, or to cover or disguise a scar.
Before getting a tattoo, it's important to ensure that your scars are fully healed, which typically takes about a year, though waiting longer is ideal. You should also have completed and recovered from any chemotherapy or radiotherapy treatment. Always consult your treatment team before proceeding.
Choosing a Tattoo Artist
When choosing where to get a tattoo, it's important to find an artist who makes you feel confident and comfortable, has experience with mastectomy and scar tattooing, and understands your goals.
If you know someone with a tattoo, ask them about their experience. It's also wise to visit several tattoo studios for consultations to understand the process, evaluate the cleanliness of the studio, and determine if the artist can create the design you want.
When consulting with your tattoo artist, here are some important questions to ask:
- Do you have examples of mastectomy tattoos that I can see?
- Have you worked with individuals who have had breast cancer treatment before?
- Do you have experience tattooing around scars?
- Can my tattoo be done in a private room?
- Can I bring a friend or family member for support?
- How long will the tattoo take, and will I need multiple sessions?
- Can I see the design beforehand to ensure I’m happy with it?
Ensure the tattoo artist is registered and holds an up-to-date health and safety certificate, which should be displayed in the studio. You can verify their registration with the local authority.
The artist should also ask about your health, including any allergies or conditions, and be informed of any medications you’re taking.
What Happens When You Get a Tattoo?
- Sessions: You may need multiple sessions to complete your tattoo.
- Tattooing Process: Tattoo artists often incorporate surgical scars into the design rather than injecting ink directly into them, although this is sometimes possible. Scar type and location can affect the design, so your artist will advise you on what works best.
- Aftercare: Your tattoo artist will provide aftercare instructions. You won't receive a local anesthetic, so the process may be painful, varying from person to person. Discuss pain concerns with your artist.
Risks of Getting a Tattoo
- Infection: Sterile equipment and fresh needles are essential to reduce infection risks. If redness, swelling, fever, or a high temperature occur, contact your GP or nearest urgent care center immediately.
- Other Risks:
- Allergies: Rare allergic reactions to pigments may occur, and some studios offer a patch test beforehand.
- Fading: Tattoos naturally fade over time. Avoid sun exposure, swimming, and intense exercise for two weeks post-tattoo, and use sunscreen to slow fading.
- Changing Your Mind: Tattoo removal is possible but expensive, painful, and not guaranteed to be fully effective.
- Side Effects: The tattooed area may be swollen, red, itchy, dry, or flaky, but these symptoms should subside. For those with black or brown skin, redness may be harder to detect. Bruising may also occur.
- Lymphoedema Risks: There's limited evidence that tattoos increase the risk of lymphoedema, but infections post-tattoo may raise this risk. Consult your treatment team if concerned.
Aftercare
- Hygiene: Always wash and dry your hands before touching the tattoo. Keep the area clean, dry, and covered as recommended by your artist.
- Clothing: Avoid wearing a bra and opt for loose, natural fabrics while the tattoo heals, which may take around three weeks.
MRI Considerations
- MRI Scans: If you need an MRI, inform the radiographer about your tattoo, as some inks contain metal traces. Most tattoos are safe, but if you feel heat or discomfort, alert the radiographer.
Tattoo Inspiration
- Design Ideas: Browse online galleries, tattoo artist websites, and social media for inspiration. Personal Ink (P.Ink) and the Mastectomy Tattooing Alliance offer examples. You can also explore online forums for ideas and experiences shared by others.
These guidelines will help you make informed decisions and care for your tattoo properly.
Tattoos After Reconstruction Surgery
Breast cancer reconstruction can be done using different techniques, depending on factors like the type of mastectomy, patient preference, and overall health. Here are the main types of breast reconstruction:
1. Implant-Based Reconstruction
- Saline or Silicone Implants: Implants are inserted to recreate the breast shape. These can be done at the same time as the mastectomy (immediate reconstruction) or at a later time (delayed reconstruction).
- Tissue Expanders: Sometimes, a temporary tissue expander is placed under the chest muscle and gradually filled with saline over weeks or months to stretch the skin and make room for a permanent implant.
2. Autologous (Tissue-Based) Reconstruction
- TRAM Flap (Transverse Rectus Abdominis Muscle Flap): Tissue, including muscle, fat, and skin, is taken from the lower abdomen and used to reconstruct the breast.
- DIEP Flap (Deep Inferior Epigastric Perforator Flap): Similar to the TRAM flap, but only skin and fat are taken, sparing the abdominal muscle, which can reduce recovery time and preserve abdominal strength.
- Latissimus Dorsi Flap: Tissue, including muscle, skin, and fat, is taken from the upper back and moved to the chest to form a breast. Sometimes, this is combined with an implant for added volume.
- SIEA Flap (Superficial Inferior Epigastric Artery Flap): Tissue is taken from the lower abdomen, similar to DIEP, but uses different blood vessels. It’s less commonly used and suitable only for some patients.
- TUG Flap (Transverse Upper Gracilis Flap): Tissue is taken from the inner thigh to reconstruct the breast, often used when abdominal tissue isn’t an option.
- PAP Flap (Profunda Artery Perforator Flap): Tissue is taken from the upper inner thigh, preserving muscle and using only skin and fat.
3. Combination Techniques
- Hybrid Reconstruction: Combines both implant-based and autologous techniques. For example, using a small implant with a flap to achieve the desired breast shape and volume.
4. Nipple and Areola Reconstruction
- Nipple Reconstruction: A new nipple can be created using tissue from the breast or other body parts.
- 3D Tattooing: A tattoo artist can create the appearance of a nipple and areola with shading techniques that make it look three-dimensional.
5. Fat Grafting (Lipofilling)
- Fat Transfer: Fat is taken from other parts of the body (like the abdomen or thighs) using liposuction and injected into the reconstructed breast to improve shape, volume, and symmetry. This technique is often used in combination with other methods.
6. Oncoplastic Reconstruction
- Combination of Cancer Surgery and Plastic Surgery: This approach combines the removal of the tumor with immediate breast reconstruction to optimize cosmetic outcomes. It’s often used in breast-conserving surgeries.
7. Delayed Reconstruction
- Timing: Reconstruction can be delayed until after other cancer treatments, like chemotherapy or radiation, are completed. This can involve any of the techniques mentioned above but typically takes place months or years after the initial mastectomy.
Each method has its own set of advantages, disadvantages, and suitability depending on the individual’s situation. The choice of reconstruction type is a decision made between the patient and their surgical team based on the patient's goals, health, and the specifics of their breast cancer treatment.
Transgender/ Non-Binary Top Surgery
Transgender top surgery refers to surgical procedures that alter the chest to align with a person's gender identity. The type of surgery varies depending on whether the individual is transitioning from female to male (FTM) or male to female (MTF). Here are the different types of transgender top surgery:
1. FTM (Female-to-Male) or Transmasculine Top Surgery
- Double Incision Mastectomy with Nipple Grafting
- Procedure: This involves making two horizontal incisions along the bottom of the chest to remove breast tissue. The nipples are removed, resized, and repositioned to create a more masculine appearance.
- Ideal Candidates: Typically recommended for individuals with larger chests or those who want a more defined masculine contour.
- Scarring: Results in visible scars along the chest, which may fade over time.
- Peri-Areolar (Keyhole) Surgery
- Procedure: Involves making an incision around the areola (the dark skin surrounding the nipple) to remove breast tissue. The skin is then tightened around the areola.
- Ideal Candidates: Best suited for individuals with smaller chests and good skin elasticity.
- Scarring: Results in minimal scarring around the areola, which is less noticeable.
- Buttonhole Technique
- Procedure: A variation of the double incision method where the nipples are left attached to a small pedicle of tissue and then repositioned, preserving sensation better than with free nipple grafts.
- Ideal Candidates: Those looking for a balance between nipple sensation and chest masculinization.
- Inverted-T or T-Anchor Surgery
- Procedure: Combines horizontal incisions at the bottom of the chest with a vertical incision up the center of the chest, often used for individuals with very large breasts.
- Ideal Candidates: Individuals with larger chests who require additional skin removal to achieve a flat chest.
- Scarring: Results in an anchor-shaped scar.
2. MTF (Male-to-Female) or Transfeminine Top Surgery
- Breast Augmentation
- Procedure: Involves the placement of breast implants (saline or silicone) under the chest muscle or breast tissue to create a more feminine chest appearance.
- Incision Types:
- Inframammary: Incisions made under the breast in the crease (most common).
- Peri-Areolar: Incisions made around the edge of the areola.
- Trans-Axillary: Incisions made in the armpit to avoid chest scarring.
- Implant Placement: Implants can be placed above or below the pectoral muscle depending on the desired outcome and body type.
- Scarring: Scars are typically minimal and placed in areas that are less noticeable.
- Fat Grafting
- Procedure: Fat is harvested from another part of the body (such as the abdomen or thighs) using liposuction and injected into the chest to create a fuller, more feminine shape.
- Ideal Candidates: Often used in combination with breast implants or for those who prefer a more natural enhancement.
- Scarring: Minimal scarring from the liposuction and injection sites.
3. Non-Binary Top Surgery
- Gender-Neutral Chest Surgery
- Procedure: Tailored to individuals who do not identify strictly as male or female, focusing on creating a chest appearance that aligns with their unique gender identity. This can involve partial breast removal, reduction, or contouring without a fully masculine or feminine outcome.
- Customization: The approach is highly individualized, depending on the person's preferences.
Considerations:
- Recovery: Recovery times and post-operative care vary depending on the type of surgery and the individual’s health.
- Scarring: Scarring is an inevitable part of top surgery, but the visibility and extent depend on the technique used. Over time, scars often fade, and various treatments can help minimize their appearance.
- Sensation: Sensation in the chest or nipples may be altered after surgery, with some techniques better preserving nipple sensation than others.
- Consultation: Choosing the right type of top surgery involves a detailed consultation with a qualified surgeon who can assess your goals, body type, and overall health to recommend the best approach.
https://breastcancernow.org/get-involved/volunteer-us/decorative-tattoos-after-breast-cancer-surgery