Tattooing can help breast cancer survivors rebuild lives

SINGAPORE — When Mrs Patricia Jackson found out that she had Stage 1 breast cancer last October, she decided to do a full mastectomy on her right breast and have it reconstructed in the same surgery.

But despite having a nipple reconstruction procedure in June this year, the 56-year-old housewife’s route to recovery really kicked off only after she tattooed the colour of her reconstructed nipple and areola to match her left breast.

“Every time you get dressed, you glance in the mirror, so the final tattoo was just for visual comfort, to have (the breast be) more symmetrical-looking,” said Mrs Jackson.

Breast cancer is the most common cancer for women here — about one-third of all cases, a report by the National Registry of Diseases Office from the period of 2009 to last year showed. And although more than half of them have a mastectomy, the general public’s awareness of breast, nipple and areola reconstruction and tattooing remains very low, said plastic surgeons.

Dr Karen Sng, who runs her own practice at Mount Elizabeth Medical Centre, said: “There’s the trauma of having the diagnosis (of cancer) and then needing to remove the breast. And for some patients who cannot get over the initial diagnosis, their priority is to get rid of the breast (cancer); they don’t think about the reconstruction.”

Plastic surgeons said a complete breast reconstruction process helps survivors overcome their ordeal.

“The impact of breast reconstruction cannot be argued against. It is part of physical, mental and emotional rehabilitation,” said Dr Evan Woo, who also offers nipple tattooing. “Nipple reconstruction is like the icing on the cake ... it makes the breast reconstruction complete. Very often, it actually adds to the appearance.”

Ms Aileen Wong, who was diagnosed with breast cancer early this year, said the colour difference between her reconstructed and natural nipples and areolas was a daily reminder of her cancer. It was the nipple tattooing that helped her move on, added the 34-year-old.

Lack of knowledge on details of reconstruction and fear of surgery are the two main reasons breast cancer patients do not opt for breast and nipple reconstruction, plastic surgeons said.

“A lot of our patients are surgery-averse. So even if you tell them it’s a minor surgery compared with the first stage, some people (are so against) the idea of having another surgery, they would rather do without,” said Dr Sng.

The shortage of public resources on the entire reconstruction process prompted Dr Woo to start a non-profit organisation with a group of plastic surgeons, called Breast Reconstruction Awareness Singapore.

Currently, there is only one professional tattoo artist here who does nipple tattooing, TODAY understands.

Ms Sumithra Debi, who started seeing breast cancer clients for this service a decade ago, said she used to get a case every four to five months. Now, she gets as many as four to five clients a week, some of them referred by plastic surgeons, said the 33-year-old owner of the shop Exotic Tattoos and Piercings.

Dr Woo said such services are more widely available in the United Kingdom, in contrast to the situation here. It has clinics where doctors, beauticians and tattoo artists are offered training in tattooing for medical purposes such as nipple reconstruction and scar camouflage, he noted. He estimated that only about one-third of his breast reconstruction patients move on to nipple reconstruction.

Dr Sng said the services provided by Ms Debi could be an alternative for patients who are averse to surgery.

“There are these new techniques of 3D nipple tattooing ... it’s a fairly new technique, but that would help to save the patient a nipple reconstruction procedure,” she said.

Seeing the difference it makes to these women’s lives, Ms Debi said she wants to continue helping them. She is also seriously considering tattooing in hospitals, which was suggested by doctors who have been working with her.

To raise more awareness, she is redesigning her shop’s website to include a section dedicated to breast cancer patients. It will be ready in October, which is Breast Cancer Awareness Month.

“I’ll have the information on what to expect, what is the down-time, what’s the healing, what to do and what not to do — questions that they don’t have to call and ask somebody awkwardly,” she said.