the long and winding road of breast reconstruction

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.


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 for further info when contemplating decisions.

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#tattooing, the final step in the long, winding road of #breastreconstruction #mastectomy #brca #breastcancer

68 thoughts to “Tattooing – The Final Step in the Long & Winding Road of Breast Reconstruction”

  1. No chosen tattoos for me, but I do have a smattering of tiny radiation tattoos all over my front. So, now, if someone asks if I have tattoos — they probably have butterflies and barbed wire ink in mind — I can say, “Yep, I have about 12 of them!”

    1. Jacki, Well, I guess you can say that can’t you? And only the people you choose to tell the truth to will ever need to know. Thanks for sharing.

  2. Ah Nancy, I can related to SO much in this post. All that undressing just gets too much. Patient has well and truly HAD ENOUGH!!! I’ve generally managed to handle all these intimate consultations with a hefty dose of humour, but that seems to be wearing out now.

    Much like you, I think getting a tattoo wouldn’t even be on my list of things to get done, and yet I also found myself in the same dentist type chair discussing colours – I had single mastectomy so it was a colour matching discussion, rather than starting from the full range. I didn’t know if I could actually go through with it when the time came – I had these discussions before my nipple recon surgery.

    After much discussion with my surgeon, and research and asking other patients, I then decided to have my areola ‘created’ using a skin graft from my upper thigh/buttock with a general anaesthetic – ouch, yes it did hurt afterwards. And then the nipple was scabby and horrible for weeks – hard to be patient about scabby nipples! Now I’m only four weeks post surgery and things are settling down and so I can decide not to have a tattoo to add more colour to the nipple bud and/or areola. I think I’m going to be happy with what I’ve got. But also, I’ve just had enough too. Five years of this nearly. That sounds like enough to me!

    Funnily enough, when I was in hospital recently they wanted to do the photos (again – can’t tell you how many of them I’ve had done) and like you, I just said ‘no’. I wanted to walk out, walk away, and no, no drum roll either. Sigh.

    Hope you are happy with the result. Sarah

    PS Interesting that in the US your surgeons do the tattoo-ing. In the UK that’s unusual and it’s usually a trained nurse or specialist that does it.

    1. Being Sarah, I think the only way a person really can get through some of those awkward moments is with a sense of humor, although I don’t think there was much to laugh about at the beginning consults. It must be an entirely different experience when you are doing the matching thing. It is pretty amazing what they can do isn’t it? I’m glad things are settling down for you and that you are satisfied with what “you’ve got.” It just gets to be enough doens’t it? Five years, that’s definitely enough! Also, my surgeon did have a list of tattooing artists/specialists, but I wanted it done in a medical setting. Too many worries for me to choose a different setting. Thanks so much for sharing your thoughts and for “getting it.”

  3. That’s so good that you thought to have your husband come along. And now that you’ve healed, how do you like it?

    This is interesting for me to read because I never had it done. I had just reached my limit of procedures. After waiting through all the chemo & trying to fit it into my schedule, I finally decided I couldn’t be bothered. I think not being able to take a bath or swim while I healed from taking skin to build the nipple suddenly seemed like just too much for me.

    Can I ask a couple of questions? And if this is way TMI, please say so & don’t answer!!!

    Since I didn’t have the nipple rebuilt I’ve often wondered about the nipple I missed. How erect is it? How noticeable is it through clothes? sometimes, especially in a summer dress or swimsuit, I do miss having 2 nipples – it does look odd getting out of a pool. But is it weird to always have one pointing out?

    Again, sorry if this is too weird or personal to be asking. For 10 years I’ve been wondering about this, but never had the opportunity or felt comfortable enough to ask.

    1. Julie, I’m sure Nancy will be along to reply to you herself, but wanted to give you my answers to your questions. I must say that I found it very difficult to find women to talk to about the whole nipple recon procedure to help me decide which way to proceed. Maybe once women have the nipple recon they feel ‘finished’ and step out of breast cancer discussions? I’m not sure.

      Anyway – my surgeon has always said to me that there are a number of different ways of making a nipple – ‘because none of them are perfect’. So, the way I chose, which is my surgeon’s preferred way, is to have the nipple bud created from skin on the breast mound – this is called a ‘skate flap’ (there are other ways of doing this). And then the areola as a skin graft as I described. The nipple bud is larger than the other side, it’s not ‘pointy’ but larger and quite soft. It will gradually flatten and become similar to the other side but will always be in the state it’s in – ie it’s protuse, it won’t flatten like a ‘real’ nipple. I am perfectly happy with it as it is – in fact I’m delighted with it, it’s gently protuse, rather than ‘sticking out’. The healing weeks have been a bit of a pain, but I could have a shower and bath only 10 days after surgery, so not too bad. Can’t swim yet, but will be back soon.

      So, that’s my nipple recon in brief. I am wondering if this might actually be a subject for a whole blog post! Glad you felt comfortable enough to ask here Julie. Best, Sarah

      1. Sarah, Thank you so much for explaining the procedures you had. I’m glad you brought up the fact that there are different methods surgeons use to create a nipple and areola as well. My surgeon called my nipple procedure a star flap, sounds pretty much like what you had done, just a different name. It’s good for women to know about the graft method for creating the areola as well as the tattooing. It’s so important for women to know they have options. That’s why this discussion is so important. Thanks for adding to it.

    2. Julie, Like I mentioned in the post, I’m satisfied, not thrilled and I’m ready to be done. I may need some touch-up later, there are a couple tiny spots where the dye didn’t take, but for now, I don’t want any more done. I really understand your hesitation to do this part. I think you can still do it if you want to, even after ten years. You can go ahead and ask the tough questions, I mean that’s the whole point of sharing isn’t it? I think every person’s results turn out differently, every patient and every surgeon is unique. It is a bit odd to always have them “showing,” but not a big deal to me; you just have to be aware and choose the right undergarments for whatever look you want or don’t want. Thanks so much for commenting and for asking questions too. Others are probably wondering the same things. Any more questions, ask away!

  4. Interesting. Here in Nova Scotia, Canada, tattooing is not covered by medicare or insurance, and you have to go to a tattoo parlor to have it done. The doctors keep a list of “approved tattoo artists” that they have checked out for cleanliness and skill, but essentially you are on your own for that.
    I have one diep flap reconstruction and one implant. We constructed a nipple like bump on the diep side. Since it was an all-in-one mastectomy reconstruction, and there was lots of skin, the implant was just put into the skin flap and didn’t go behind any muscle. The only draw-back to that is that it is not tethered in any way and does slow somersaults in there and sometimes I can feel the edge and others the fill port.
    I have chosen not to have the tattooing done: not sure if it is patient fatigue, apprehension about tattooing or the fact that i have had so many post surgical infections that I don’t want to do anything non-essential to my body.
    It cones down to personal choice, and here whether you can find a tattoo artist who can do flesh tones, and if you trust them!

    1. Elaine, Thank you so much for sharing about your experience. My doctor had a list like that too, but like I mentioned to Julie, I wanted a medical doctor. I’m sure the people on the lists are alright to use. I understand your decision to not do it, patient fatigue, I totally get that. There does get to be a point where you just say, no more. It is a personal choice, the whole process of reconstruction is actually, or should be. Thanks again for commenting.

  5. Excellent post Nancy. Yes, at this point enough is enough. It’s weird how we think there’ll be a feeling of jubilation at the end of it all, but I haven’t met anyone yet for whom that was the case. Anyway I’m glad this was the last step for you, and I think this kind of post is very helpful for women who may be contemplating these types of procedures, as was Being Sarah’s post on this same topic. Brava 🙂

    1. Rachel, Thank you for the compliment. I do hope this post and those by others help women who are contemplating these big decisions.That’s the whole point of sharing this personal stuff. Sometimes I don’t think it’s made clear to women what a long process reconstruction of any kind is. You’re so right, enough is enough is enough, as you know only all too well! The end was pretty anti-climatic and I was surprised there was no follow-up unless I had a problem. It is nice to finally be at this point. Thanks for commenting.

  6. Hi Nancy, 3 hours until my date with destiny. I love your post here. Thank you for writing about this, as difficult as it is. I only managed to write about it by cleverly avoiding the word “nipple.” I never once mentioned it. Tricky, but it got the job done.

    I don’t have any tattoos either. I don’t think I’d ever choose to get one. I like that you said you were satisfied. Good word, that’s how I feel. Am I thrilled with what I have? No. Do I think my fake breasts, look amazing? Natural? They are different from what I had. The new nipples didn’t shrink down evenly and don’t quite match. I’m hoping my surgeon doesn’t have an issue with that, but as you said, I’m satisfied. I don’t want anymore nipple work. After today, I’ve gone as far as I”m going to go. Thanks for being there and being so open about this. It truly helps knowing I’m not the only one.

    1. Stacey, I hope your appointment goes well. I’ve been thinking about you and reading your post kinda helped me push the publish button on mine. My shrinkage was not the same either, if you know what I mean, and I think you do! ha. I do not have a perfect match, not even close. At this point, I don’t care and I figure I can always do more work later if I choose to, but for now things are good enough. Thanks for sharing so openly, too Stacey and no, in this you are not alone either. Thanks for your comments.

  7. Ah, Nancy, even if getting a tattoo were on your list of things to do, I doubt very much you’d ever have wanted one under these circumstances.

    I did always want to get a tattoo, but never got around to it. After I was tattooed for radiation, I was so annoyed that radiation beat me to it, I decided to get a deliberate one for my first birthday-after-cancer. I drew a Celtic-knot circle, NOT pink, but purple, and brought the design with me. I went with another BC sister to a tattoo artist she’d gone to before, who was a very nice, competent guy. The tattoo was placed on my thigh, and it really didn’t hurt much at all, certainly nothing like some of the atrocious procedures I’d already endured as a cancer patient. And it turned out that my tattoo artist’s sister had died of breast cancer a few years before. So, it ended up that he & my BC GF & I had a very poignant experience together. You never know when you’re going to make that connection with someone. All in all a very fond memory now.

    I hope this is really IT for you, Nancy!! I can’t believe you’ve gone through what you have gone through. I still haven’t gotten over the “just leave me and my breasts the heck alone” feeling from acute treatment. It must be a kind of torture to deal with all this, even with a desirable outcome.


    1. Kathi, You are certainly right, I never would have chosen to get a tattoo under these circumstances! Good for you for getting that post-cancer treatment tattoo. Isn’t it interesting, and sad really, that even your tattoo artist had this breast cancer connection? I’m glad the tattooing experience stirs up fond memories for you. I hope this is IT too, Kathi and I don’t know if I’d call it torture, but it’s certainly all been unpleasant. Thanks so much for sharing about your tattoo and for caring.

  8. Thank you so much for this post Nancy. I can absolutely relate to all of this and at this moment in time I’m actually waiting on a date for my own tattooing. Fortunately my Breast Surgeon will be doing the “ink” for me so i’m quite eager to see the final results. Since my first surgery in Feb 2011 I have continually read your posts and have found them to be an amazing support mechanism. I was truly blessed the day I came across Nancy’s Point. It has most definately made my own long and winding road that little bit more bearable. Thank you for the many hours you must have shared with us all so far. x x

    1. Amanda, Thank so much for your very kind words. They mean a great deal to me. I always wonder when I post this stuff if I’m sharing too much, but then I keep hoping there is someone out there like you who might benefit or relate. So reading your words means more than I can say. Good luck with your tattooing. The procedure itself is not bad at all. It’s more the mind games, or at least that’s the way it was for me… and something so permanent, you just want to get it right. Let me know how things go for you and thanks again for your comments.

      1. Please don’t ever think you are sharing too much! I am a 51 yr old woman, adopted as an infant, who found out in my early 20s that my biological mother, grandmother, and great grandmother all died in their 40s or 50s from breast cancer. There were mitigating circumstances in all cases (including just the times it happened- my birth mother passed away in the mid 80s) but it’s a thing that has hung over my head ever since, especially since I didn’t have health insurance at the time I found out, nor could I get any for over 15 more years, until I moved in with my now-husband with his union job (though Planned Parenthood were absolute HEROES for the efforts they went through trying to find a place that would do low cost mammograms for women under 40.)
        I haven’t had the genetic testing done yet, because I am too scared of getting kicked off our insurance and/or becoming uninsurable if I am positive, which would be disastrous as I already have several lifelong serious chronic health issues that require constant medical care & daily medication (that is far too expensive for us to afford out of pocket) but I am seriously considering going through one of those genetic ancestry/gene testing services (and possibly using a false name so they can’t transmit information to insurance companies) just for the peace of mind that knowing (either way) would bring.

        POINT: your blog is a valuable and comforting* source of information for someone like me, who merely has that threat hanging over their head. I can only imagine how it is for those who are already facing this disease. THANK YOU for doing this. No detail is too gory, no thought too raw or uncomfortable, no admission too TMI, because it is the reality of the disease.

        *I find unvarnished facts and blunt reality comforting

        1. A Nonny Mouse, Thank you for sharing all that. I would suggest speaking with a genetic counselor about your history. He/she could offer good information, guidance and resources. Discrimination based on genetic testing is supposed to be illegal. I know there are always loopholes to worry about. And under the ACA, genetic testing and counseling are covered when certain criteria is met, which in your case, it likely is. Check out this link: Good luck with things and thank you for your kind words about the blog.

  9. I had my tattoos done TWICE. And, I can’t scroll up because I will forget what I want to say, but I had “nipple reconstruction” before the tat’s were done. That was done in an operating room because the surgeon wanted to do fat injections. I am glad he did both. I do like the end result. IN CLOTHES. That’s the big issue. In clothes, I am comfortable and confident. But, I think that’s the subject of a whole other post and a completely other issue…..

    I can only see the “nipples” in a couple of things I wear-and I will admit I kinda like the way they look. I’m SURE it’s because I know they are not mine and as I’ve said on so many occasions (most recently after my run in with the TSA and being felt up), these things are merely adornments much like a pair of earrings.

    I should also add I’ve had my “nipples” for about four years. They’ve grown on my (like a pair of earrings that I enjoy wearing-not necessarily a favorite pair, but definitely a pair I like!)

    Enough IS enough…. As it is, I’m already in the “these gummies are in for over four years now. I KNOW they are going to have to be swapped out for new ones and I am approaching that window of time….. Just one more thing to think about….. Just as the scars begin to fade (in my own yes), they will be reopened.

    Thanks Nancy for a capturing the experience perfectly. Thanks for sharing and I always find myself nodding my head when I’m reading (as IF you can see me nodding!!)


    1. AnnMarie, I had the nipples done last spring along with my other two surgeries. That was an assembly-line affair. Ugh… I’m glad you are mostly pleased with your results and things do “grow on you” over time don’t they? There is one thing after another to adjust to it seems. What other option do we have though really? Thanks for sharing and thanks for all that nodding too!

  10. Hello,

    Thanks for sharing ladies. It is very difficult to find information about all this “Nipple /areola”subject.

    I will very soon have an appointment with my plastic surgeon about nipples and areola…. Choices are to create new ones with skin of my tights or just tattoos. I am so confused and as Julie does I also need a lot of answers. I would like to know if partners like/enjoy the new additions.

    What I know by sure is that it must be done now or never.


    1. Lola, It is really hard to find much information on this part isn’t it? When you have your appointment, be sure to have all your questions addressed. You don’t want to go into this, or any medical procedure, confused. You definitely need and deserve to get answers. As for your question about partners, well my hubby supported me no matter what I decided to do or not do, but I’m sure he’s happy I finished things off. Thanks for commenting and good luck. Let us know how things go.

  11. Thank you Nancy for sharing your experince. As a doctor in a breast unit I perform the tattooing. May I encourage other women to consider this as part of the breast reconstruction. A nipple with colour makes a breast feel more normal and makes the scars less obvious as your eye is drawn to the nipple. The pigments used are semi-permanant and similar to those used with semi-permanant makeup. The colours will fade over a few years but can be topped up. Often I would see my patients for two or three sessions to build up the colour and make it last longer. It is also possible to use a tattoo technique to remove tattoos and this is possible for the radiotherapy marks. Can I say that seeing women on their journey from time of diagnosis to completion of treatment and reconstruction is a privilege and makes the hard work worthwhile. Blogs like this are a great insight in to how patients view their journey…THANK YOU

    1. Gwyneth, You’re right, the nipple and the color do make the breast more normal looking and they also definitely draw the eye away from those nasty scars. Still, it is another procedure and a woman sometimes has reached her “procedure saturation point” and just doesn’t want any more. The nice thing here is that this part can be done any time, even much later on down the road. I didn’t know you could remove the tattoos and radiation markings, so that’s good to learn. Thank you so much for your kind words about my blog and thank you for taking time to read and comment. It’s good to know there are caring doctors out there who want to learn about how patients are feeling and coping. That means a lot.

  12. Thanks Nancy. Until recently I had not thought about being tatood to complete my single mastectomy reconstruction. I thought I was OK with what I had, but a friend gave me some sample temporary tatoos recently, and after applying one I realized how much better I felt looking at a matched set. I don’t know if I’ll go ahead with a permanent tatoo, but for now I’m using the temporay ones successfully.

    1. Betty, I’ve heard other people talk about the temporary tattoos and they sound like a really good option to consider when deciding or if you choose to not do the tattooing at all. Are they hard to keep on? I’m glad you’ve found something that works for you. Thanks for bringing this option into the conversation, Betty. We all learn from each other.

  13. I love your post!! I must say that I admire your sense of humor about the whole recontruction process! Thanks. Please update us about how does it finally look and feel. I was once told by a friend that once you have a rconstructive surgery, never think of your breasts as foobs (fake boobs) and try to think of them as your own. I always kept that in mind and have always felt great about them. I just need to get the tattooing part done. I will get that done in 2012 🙂

    1. Shikha, Thank you, I’m glad you liked the post! I think a person has to maintain a sense of humor whenever possible. It can really come in handy in the plastic surgery realm that’s for sure. I’m finding I’m feeling better about how things turned out and how things feel as time goes on. I’m also finding it takes a long time for my body to adjust. Would I go back to my “old ones?” Yes, in a heart beat, but I also know I made the right decsions. I’m glad you are pleased with “yours” and good luck with the tattooing. Keep me posted! Thanks so much for commenting.

  14. Nancy Congratulations on your nipples? Or is that politically incorrect to congratulate someone on nipples? seriously it is a long hard road and it is an accomplishment when you consider all the other obstacles.
    I do have tattoos, in fact I have 3 and I will be getting a 4th eventually when I figure what I want. My first tattoo is the Eye of Horus black ink only. Then I have this other of my own design on my back , I should say my Eye is on my left shoulder blade the other opposite side. 3rd one a Celtic Symbol for peace. The 4th I’m still working on that not quite sure oh lets not forget the ink dots for Radiation that I never had. I like tats, it’s something personal you decide on and it can symbolize anything . I thought about the date I found out I had Breast Cancer but I already never forget.. I say go for it, It really isn’t painful and certainly not as bad as what we have been through anyway in losing our breasts

    Love Alli XOX

    1. Alli, You’re right, it is a long hard road. I guess it is an accomplishment of sorts, although I don’t really think of it like that. It sounds like you have some interesting tattoos. They are very personal aren’t they? Like you said, even the ones a person chooses are done to make some sort of statement. Did you read Gywneth’s comment? I guess those radiation tattoos can be removed… Thanks for commenting and for sharing about your tattoos.

  15. Nancy, Nipples are definitely a sensitive subject but, from the number of responses, clearly a very important one to be addressed. For me, there was no question to get one created and now I am just awaiting the areola tat, hopefully next month. I wanted to look as “natural” as possible, though these days, that requires squinting and a little imagination, ha! I find a single mastectomy provides the challenges of asymmetry as well as the constant reminder of what is changed, with my left breast still here. And even that poor twin did not go unscathed, as a mastopexy was needed or my chest would really be lopsided. Lately, I’ve seriously decided a bilateral would have been easier in the long run, though I would never have admitted this in the esrly days. Not only is the visual difference in the mirror every day (and I know my plastic surgeon did the best he could) but I still need to go in for mammograms….ugh. It is a consolation with reconstruction that we can still look “normal” when clothed. We got that going for us.

    1. Mary, It is a sensitive subject for sure and I can’t really figure out exactly why that is. I’m sure it has been more challenging in some ways to keep one breast. I remember my plastic surgeon saying getting symmetry is quite difficult. I didn’t have to worry about that… And I’m sure it is somewhat odd to face “the two” in the mirror each day and always have that visual reminder… We just carry on and adjust the best we can don’t we? Thanks so much for adding your thoughts to this discussion, Mary.

  16. Nancy, thank you for your authenticity. You write from the heart and I often feel as though you are reading my mind. It IS uncomfortable saying certain words out loud, but your unflinching post nailed the final procedure on the long road of breast reconstruction.

    1. Eugenia, I’m glad you found this post helpful. Did you notice my other post on reconstruction as well? I wish you all the best with your upcoming surgery. Thanks for taking time to comment.

  17. About temporary tatoos. Nancy, you asked if they hard to keep on and the answer is no. Depending on the type of bra, blouse, shirt etc that you wear and how hard you scrub when you shower, they can last from 2 to 4 or more weeks. They don’t just fall off but instead start to look a little “shabby” around the edges over time. They take just a minute to apply, but it is suggested that you apply them in the morning and wait 15 minutes to let them fully dry before dressing.

    I have not had nipple reconstruction. Some of the temp tatoo options are 3-D which are kinda cool. Rubbing alcohol removes them. I think they are a great option. I’m still trying the different colors so to find the one that’s the best for me. I’d be happy to list the web site that I use if that’s OK with you.

    1. Betty, Thank you so much for this additional info on temporary solutions. I had no idea they stayed on that long. I would love for you to give that web site. I have another question, is this product a nipple/areola combo then? Thanks again for sharing.

    1. Renn, So you plan to do the tattoos for areola, but not nipples then? I was a bit confused by what you meant. I guess I would say, I’d rather have headlights on then not have headlights at all! ha! I’m just kidding of course!! I couldn’t help myself with that one. Sorry everybody who’s reading… Check out Betty’s comments, too, for temporary options until you’re ready for more permanent ones.

    2. OK Miss Renn….

      If you don’t want the nipples reconstructed… Have the tattoo done to give the appearance of “headlights” ….. They can do that too…


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  19. Hi Nancy, If it were me, I have no idea how I would feel or what I would do about breast reconstruction. I honestly did not know that tattooing would be one of the things that I might have to decide about during the reconstructive process, until I read your post. I guess you can never truly know what you would do unless you are there, right in the moment.
    I think that it is wonderful that you are writing about such sensitive matters in such an open way. I am sure it is such a help and comfort to so many women facing the same problems and decisions. Just as you needed the reassurance that your husband’s company provided, your writing is sure to provide that little bit of solace to so many.
    Congratulations on completing the reconstructive process. You are an inspiration to us all.

    1. Jennifer, You’re right, until you are faced with this stuff, it’s all almost unfathomable. I mean discussing nipples and tattooing, who would have thought? The fact that you read through the post and took time to comment says a lot about you. I really appreciate that, Jennifer. So, thanks for your very kind words, but more than that, for your understanding and support. Thank you.

  20. Thanks Nancy for your great blog, women need to know their options out there and I love your sence of humor! I’m a Permanent makeup artist and have been in practise for ove 15 years! I specialize in restoring the color in the areola and nipple after breast reconstruction. It is my most rewarding procedure and I just love these wonderful women as they are the True Heros!!! I’m located in San Diego, Ca on the campus of Scripps Memorial Hospital.

    1. Vicki, Thank you so much for saying such nice things about my blog and for appreciating my humor! More importantly, thank you so much for the work you have been doing for 15 years and are still doing! That’s amazing and you mentioning how rewarding your work is for you says something pretty special about you. Thanks for taking time to read my blog post and also for commenting. I appreciate it very much.

  21. Nancy, Congratulations on being done.

    I had the double mastectomy with delayed reconstruction. I had radiation tattoos twice, but never had the radiation due to complications and delays with my health plan. It was such a miserable experience that I had all the tattoos removed. It took over a year of laser treatments every 6 weeks, but I’m glad to be rid of them. They were just an ugly reminder.

    As for temporary tattoos, I was able to get “nipple prostheses”. Probably what Betty was talking about-3D version. They look very real and stay put. They are a very good alternative to “one more surgery or procedure”, which I could just not endure. They really help to take the eye off the scars and are very realistic and soft. And the insurance paid for them

    And for Mary who thought about doing a double just for symmetry – even with the double you don’t get symmetry. Still a little lopsided, but then again, I always was.

    Thanks again for writing about this and for everyone contributing comments. It is very educational. I wish they had this available for anyone facing the possibility of mastectomy or reconstruction. This discussion would have been so helpful- way back when…

    Dianne Duffy

    1. Dianne, I’m sorry you had such a miserable experience and I hear you about not wanting any more stuff done. I so relate. I’m glad you found a product that works for you too. It’s nice that there are some alternatives out there. Thank you so much for adding to this important topic of discussion. It is very educational isn’t it? I’m astounded by the response and everyone’s willingness to share so candidly. That’s pretty great. At least that’s progress to celebrate isn’t it?

    1. I also used these rub on nipples – they are flat, but the shading is good and creates a slight illusion of 3-D. The do lots of shades and you can get mix packs to try and find the best match (for one nipple), or your preferred shade for two. I really ‘liked’ these a lot.

  22. Nancy, I just had to read your posting and the many comments it elicited. I know what you mean about the saturation point for even more procedures.

    I had nipple buds and when they healed, the tattooing had begun. I thought this “final” process would be a joyous one, but it was anything but.

    I emotionally couldn’t handle all the blood and other bodily fluids oozing out of me for both procedures. I sobbed each time I had to change the dressings, and I was in torment and anguish. At that point, like you, I had too many damn things done to my body.

    The nipples threw me for a loop. Now, less than five years later or so, I’m satisfied, like you. But not one day goes by that I don’t think about reconstruction. I love my body/hate my body.

    My tatoos are starting to fade, and I don’t think I’ll ever have them touched up. It would be too damaging for me psychologically. I can’t bear to see anymore of the gore on my breasts.

    My breast-cancer affected breast was so damaged by the radiation and three lumpectomies that the breast looks acceptable, but is a size smaller than the other breast. My plastic surgeon did as good of a job as possible, but there are limitations. Turns out, I wear a prosthesis on my right breast.

    Like someone said earlier, clothed I feel terrific and even beautiful. But when the bra comes off at night, then the demons appear.

    Thanks for writing a terrific post. I hope things go well for you regarding the tatoos and am glad you are “done” with the physical part.

    1. Beth, All of us reach a saturation point at some point I think. I know what you mean about that lack of joyousness after the “final process.” It just didn’t happen for me either really. I’ve heard the tattoos begin to fade with time and I don’t know what I’ll do then. In fact I have some spots where things “didn’t take” right now, but as I said, sometimes good enough is just that, good enough. I’m sorry to hear those “demons” still appear for you. You aren’t alone in that either though, Beth. Thanks for sharing so honestly.

  23. Another difficult subject that deserves discussion…way to go Nancy!
    I opted for the double masectomy with no headlights. I never liked nips and for the most part, wore bras to hide that function. I just never cared to have guys staring at my chest, just shy that way. So I knew right away that I didnt want that procedure. However, I did opt for the tattoos and I am glad I did.
    My insurance paid a cosemetic/permanent make up person to do it. She was highly recomended, and it turned out that my visit to her was very pleasant as she was the nicest person I had been in contact with through the cancer nightmare(not that any one had been horrible, she was just an angel to me when I needed it most). She had done nipple tattoos for over 10years and had many wise words to share. She let me express some of the pain and was able to reassure me that I was normal and not alone. I actually left her office with a feeling of lightness.
    As for my tattoos…they really do fool the eye when I undress. Most of the time I dont even see the scars anymore. I chose natural skin colors(I guess some gals chose bright red!) and I dont wear a bra anymore(I am still just a size B) unless I am wearing something white and then nipple color would show through, usually a camisole is all I need.
    Was I happy about having the need for nipple tattoos? Hell NO! But I am satisfied with the job they do.

  24. Nancy
    Thank you SO MUCH for writing about this. I could totally relate to your “photo shoot.” That might be one of the most bizarre experiences of my life. Well, that and the tattooing, I imagine. Don’t tell my plastic surgeon that I haven’t scheduled the tattooing yet … I’m still getting used to the idea.
    Why am I not surprised by the behavior of the insurance company? I’m so sorry that you have had to endure so many experiences where you were made to feel ‘flawed,’ or “less than’ … it’s disgraceful.
    Nancy, I LOVE LOVE LOVE your clear-eyed, compassionate writing. “see” you soon!
    Thank you!!

    1. Yvonne, Thank you for checking into my tattooing post. That was a very strange experience, one of the most bizarre in this whole ordeal. Good luck with whatever you decide to do in regard to tattooing. And thanks for you kind words as well.

  25. I am new to this blog, and am so excited to have discovered it! I know this is an old post, but wanted to see if I could ask a couple of questions. I am 48 and had bilat mast with implants after a diagnosis of BCA back in 2010, also BRCA2. I opted for no nipple recon, as I had fought the “headlights” all my life! However, I am considering tattooing, but worry that if I get the tattoos now and then I need a revision for whatever reason, will it mess the tattoos up? I am 4 years post-mastectomy, and though I like my “foobs” (fake boobs) when clothed, I really think the appearance of nipples would make them more tolerable when naked.

    Thank you and all the other readers for voicing all the concerns that have plagued me since that awful day 5 years ago!

    1. Ann, As you know there are no guarantees, so yes, if you need revisions later, things could get messed up. Still, I would say go for it. Thank you for reading. The post is an older one, but still timely. Thanks for reading.

  26. Seven years after your original post…nipple tattooing has become a much bigger thing! Many regular tattoo artists have learned this skill, and often donate their time & talents to breast cancer patients who wish to have it done. A friend of my husband’s is an incredibly skilled tattoo artist does this, and she practiced on herself, so she has nipples tattooed in some odd places (like on her legs, lol!)
    I’m a woman with multiple tattoos, some fairly large, and piercings as well, which included having my nipples pierced for many years. I’ve had a number of years to think about the options I’d have if I get hit with the breast cancer stick, like the three generations preceding me did. I think if I was in the position where I couldn’t save my natural nipples, that I would be just as likely to get something wild tattooed in place of them (like eyeballs with flames coming out of them), or turquoise blue nipples to match my hair, as I would go for natural looking nipple tattoos or nipple reconstruction, possibly even more so (it would definitely fit my personality/style.) I can see myself trying to talk the plastic surgeon into giving me two nipples on each breast or something, because I’d be thinking “hey they are already fucked up and if it’s going to be difficult to make them look natural I’d rather go FULL BODY MOD!”.
    I’m an eccentric person, and I honestly don’t expect many people to understand this, but I do want to reassure people that I’m not trying to make fun of or mock anyone for their personal choices. This would be MY way of coping with something awful, like the way I have made art or jewelry out of teeth I’ve had extracted, which I find traumatizing ENOUGH with my personal medical/body horror issues (ironically, many developed from growing up chronically ill & being traumatized by constant ER trips.)

  27. I had tattoos done two weeks ago and love them. I expect every so often when I turn sideways to see a real nipple when looking in a mirror. And actually there’s something sexy about the tattoos. I also had a floral spray tattoo surrounding the right foob and enjoy letting the top of it peek over the tops of blouses and tanks. Go for it, ladies!

    1. Christina, I’m glad you are happy with your tattoos. Mine have faded pretty dramatically, and I haven’t been able to bring myself to go back. But now, I am facing other reconstruction issues – an implant rupture. So there’s lots to figure out. Again. Thanks for sharing.

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