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

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Christina

Thursday 4th of July 2019

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!

Nancy

Thursday 11th of July 2019

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.

A Nonny Mouse

Wednesday 7th of November 2018

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.)

Scar Tissue, Tattoos and “Are we there yet?” | FEC-THis

Sunday 22nd of November 2015

[…] Nancy’s Point: The final step in the long and winding road of breast reconstruction […]

Ann

Tuesday 29th of September 2015

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!

Nancy

Tuesday 29th of September 2015

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.

yvonne

Sunday 1st of April 2012

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! y Thank you!!

Nancy

Monday 2nd of April 2012

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.

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