Tattooing – The Final Step in the Long & Winding Road of Breast Reconstruction

This past October I completed my breast reconstruction. Things are now finished on that front (pun intended). Overall, things turned out alright. Am I thrilled with the results? Hmm… no, not thrilled. Implants are still stand ins for the real deal. Am I satisfied? For now, yes. I could choose to have a few further minor adjustments made, but for now, I choose not to. I will need MRIs every two years or so to monitor things, but for now things are good enough. Sometimes good enough is just that, good enough.

I’m ready to be done. More than ready!

I’ve had enough poking and prodding, enough surgeries, enough soreness, enough unveilings, enough disruptions, enough healing, enough fine-tuning. I’ve had enough, enough ENOUGH!

You get the idea…

In some ways, the final steps on this long and winding road of breast reconstruction have been the most difficult to undergo and the most difficult to share about as well. Bringing Up Goliath is blogging about it too this week and that helps somehow. Being Sarah has also shared intimate details about her recent nipple surgery.

It’s odd that it’s so uncomfortable to say out loud, discuss or even type words like nipples, areola and tattooing.

Why do these little words make us so squeamish?

It’s taken me a while to figure out how to tackle this particular post. What angle should I take? How much is too much to share? Or should I even share about this final step at all?

It is very personal. But it’s also part of the process and therefore, should be discussed.

And since I’ve been pretty open about the rest of the process, why start holding back now?

First of all, I should explain the purpose of tattooing in the breast reconstruction realm, is to create an areola, the darkened area around the nipple. Unless you have a nipple-sparing mastectomy, you lose the nipple and areola along with your breasts. The nipple-sparing surgery wasn’t an option for me.

I’ve come a long way since that day eighteen months ago when I first stood chest to face with my plastic surgeon. After that consultation, the next most bizarre thing about that day was being escorted by his nurse into a special room for my “photo shoot.” It was, of course, for the purpose of recording the before half of my before and after shots.

Talk about feeling uncomfortable, but on to today’s topic…

I never had a tattoo before. On my list of things to do before I die, getting a tattoo wasn’t on it. But cancer steered me into many new unexpected and unwanted territories. This was just one more to navigate.

Naturally, my regular plastic surgeon (it feels odd to have a “regular” plastic surgeon) was not yet certified to do tattooing, so voila, this meant I needed to see yet another plastic surgeon. Oh the fun never ends! I mentioned to him that he needed to step it up and get this training, pronto, in order to spare his future patients more anguish. Luckily, we can be pretty open with one another, and he didn’t seem to mind me saying that.

I didn’t have to search too long or too hard for plastic surgeon number two because plastic surgeon number one recommended a colleague of his. But still, it meant more appointments, more explaining, more rehashing more uncomfortableness, just MORE…

Before I was allowed to even schedule a tattooing appointment, the procedure first had to be authorized by my insurance company. That took a while; weeks in fact. There seemed to be a fair amount of confusion as to what “this tattooing” was for. I was asked if tattooing was normally part of breast reconstruction.

Seriously?

How could a huge insurance company be so out of the loop? How could this not be a logical next/final step?

That ticked me off a bit. And then, of course, they labeled the procedure, skin pigmentation correction.

Nothing like continuing to make the cancer patient feel flawed.

Like I’ve said many times before, words matter.

When tattooing day finally arrived, once again I was surprised a bit at how cowardly apprehensive I felt about this minor procedure, well, minor in comparison to everything else anyway. I dragged Dear Hubby along because I felt totally incapable of choosing a proper color or size (yes, you can pick your size too) and I didn’t want to be responsible for a wrong decision; easier to blame him later on, right?

When we arrived and I mentioned to the nurse that yes, Dear Hubby was indeed accompanying me “back there,” she gave me a disapproving look that seemed to say something like, well that’s never done, then scurried off to get doctor’s approval even though I told her he had already approved it, which he had.

After finally making it into the dentist-like chair and once again feeling quite literally very exposed there under the lights, things got underway. The doctor teased me about color choices and jokingly said he was thinking purple since Halloween was approaching. Plastic surgeons can be such wise guys.

The procedure itself only took about forty minutes, maybe less. Hubby left half-way through after the color selection had been made and probably after deciding he had seen enough.

Surprisingly, I could feel it all a little bit, even after they numbed me up. It wasn’t painful, just a sort of prickly or tingly uncomfortableness. I took this to be a good thing, because any feeling in the chest area is welcomed post mastectomy. The needle device was surprisingly quite loud, again reminding me of the dentist with his drill.

When the surgeon and his nurse were finished, they brought over a mirror and let me take a look. I must have gasped because immediately they said, “Things will look better after you give it some time…be patient.”

A patient never likes being told to be patient.

So just a heads up if you are having this procedure, the results might look sort of scary at first due to bleeding under the skin.

Next, I was properly salved,  bandaged up and given directions about how to care for things.

Then I was finished.

No drum roll. No triumphant moment. No jubilation. Only a tiny sigh of relief that another step in this cancer shitstorm was complete. 

I asked if I needed to schedule a follow-up appointment. They said NO!

What, no follow-up?

Nope. Not this time. It was over.

Except for the healing; that took about a week.

I had reached the end of the long and winding road of reconstruction; the end of something I never wanted to begin in the first place.

Well, except for the fact I need to go back to plastic surgeon number one for the final inspection and for that “after” segment of my photo shoot. Ugh.

I think I’ll wait til next year.

Note:  Breast Reconstruction is not everyone’s choice for many reasons. Check out breastfree.org for further info when contemplating decisions.

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Have you ever had a tattoo of any kind?

How do you handle “highly personal” medical questions or procedures?