Areola Tattooing Post Breast Reconstruction
Areola tattooing is usually the final phase of breast reconstruction after mastectomy. The nipple can be rebuilt using the patient’s own skin after reconstructive surgery. This normally takes place about 3-4 months after phase 1, the transfer of the tummy tissue and blood vessels to create a warm, soft, breast mound. A 3D tattoo of the entire nipple and areola complex can also be done if a patient does not have the nipple rebuilt. Both procedures can be done as a final step to restore the breast as close to its natural look as possible.
Many plastic surgeons offer tattooing in their office but there is an alternative. You can go to a skilled and qualified tattoo artist to have these procedures done. A patient who has had the nipple rebuilt can have the areola area tattooed. Some chose not to have the nipple rebuilt and have a complete 3D nipple areola tattoo done and in the hands of a skilled tattoo artist the results are life like and quite amazing.
An Accomplished Tattoo Artist
I had the pleasure of interviewing one such accomplished and creative tattoo artist for this blog post. His name is Kenny Plaster. Kenny and his wife, Ashley, are owners of AK Lounge of San Antonio. Ashley provides professional salon services for hair and Kenny provides permanent tattooing services.
I learned about Kenny through a woman I have become friends with through my breast reconstruction advocacy and outreach. Her name is Jessica and we both had the same procedure, DIEP flap surgery, to restore our breasts after a breast cancer diagnosis resulting in a mastectomy. Jessica and I also went to the same plastic surgery group at PRMA in San Antonio. We had different plastic surgeons but were both pleased with our experience and outcomes.
I received this text from Jessica one morning.
Good morning gorgeous! Going to Kenny Plaster, a tattoo artist that PRMA recommended to get my areolas done this afternoon! I’ll let you know the outcome!
She followed that statement with the teeth gritting “nervous emoji”. I interpreted her text with both a sense of excitement due to the exclamation marks but also bit of trepidation from the emoji she put in the text. This seemed understandable to me since someone was going to be putting ink and needle to her newly reconstructed breasts and around the nipple that she had rebuilt by her surgeon, Dr. Peter Ledoux.
The texts that followed informed me that Jessica knew Kenny personally. Jessica is a stylist as well and their businesses were just a few doors from each other. After a few texts my writer’s mind began to stir up ideas for a blog. I asked Jessica to give me a quick call to discuss my ideas and ask her a favor.
I requested that she take photos of her experience and send them to me so that I could feature Kenny in this blog. One of my main goals through my advocacy in addition to guiding breast cancer patients through the process of breast reconstruction is to connect them with qualified plastic surgeons that I have carefully vetted. But then I realized that a tattoo artist is very much part of this equation for many women. I had a nipple sparring mastectomy so did not have a need for this step in the reconstructive process. Knowing that many of the women I talk to will be seeking qualified tattoo artist lead me to recognize the need to inform women about those tattoo artists that patients have gone to and surgeons have recommend.
I interviewed both Kenny and Jessica for this blog post. Here are the questions and their answers.
- How long did you have to wait between your revisions/ nipple rebuilding and getting the Tattoo?
I had my nipple reconstruction done in November 09. Kenny was able to do my first phase of tattooing at the end of February. As long as my scars were healed I was given the go ahead.
2. How did you come to choose Kenny?
Kenny worked 2 suites down from me. I was already familiar with his talent and reconnected with him when he presented at the Pink ladies support group. Cleanliness played a huge part in my decision. I knew that Kenny would provide a clean and safe environment which was a huge concern of mine.
3. Were you nervous going into the procedure?
I was very nervous going into the procedure but after talking with Kenny, and letting him know all my concerns I immediately was at ease. He answered all my questions and was very pleasant to work with.
4. Was it painful?
It was not painful. After having the DIEP with reconstruction, I have lost all feeling in my breast. However Kenny wanted to make sure I was completely comfortable and feeling no pain with his unique numbing system.
5. What care did he instruct you to do after the procedure?
This was my first of 3 sessions. The first session is to build on the dimension to give a realistic appearance. My second session will be more detailed and to adjust the color if needed. I was instructed to use Silver solution and to cover with nonstick pads. After about 7 days it started to flake a little so did use a little Vaseline.
6. Was the cost covered by insurance?
Kenny offered to do mine for free. He was training an artist from Austin and using me as a breast model. I am not sure of the cost. You may want to check with him on that. I think he charges 350.00 an Areola. I do know that if you want to submit with insurance it can vary depending on your coverage. A PRMA nurse will write you a letter of medical necessity to submit with your receipt of payment to your insurance.
Kenny’s Interview via our phone conversation:
Kenny began doing tattoos on himself as a child in middle school around the age of 13. He shared with me that he had a difficult upbringing and that his current work as a tattoo artist brings him a great deal of joy. In fact, he said now, as an adult, he works on “chasing down happiness” every day. He relayed to me that he is simply amazed at what his work can do for clients.
Tattoos and the “Bad Boy” Reputation
I asked him to tell me about the history of tattooing. Kenny said that for many years tattooing developed a bit of a “bad boy” reputation. In fact, he said that because of the techniques used in many tattoo parlors, there is pain involved in the process when not done by a skilled tattoo artist like himself. The images and choices for tattoos often reflected that; demons, swords, malevolence. Kenny told me that over the years he has often heard the phrase, “I’m going to go get some pain” when someone wanted to go in for a tattoo. He stated it was part of the aura, the nature of getting a tattoo.
This is not about pain. This is about Art. ~ Kenny Plaster
Now he and many other skilled “skin artists” are trying to dispel this idea with art, beauty and meaning behind those images that people wish to have tattooed. He wants people to see tattooing from more of an artistic standpoint than that associated with evil and criminals.
Kenny takes an organic pigment using high quality needles that do not place undue trauma on the skin. He uses a numbing spray that also kills any bacteria around the area he is working on. He told me that these quality needles are hard to come by and part of the success of his tattoos are choosing the proper needles.
The Intricacies of Tattooing
Kenny explained to me that it takes a very skilled eye, special equipment and touch to place the ink at just the right layer of the dermis. The firm skin or very top layer of the dermis grabs the ink the best. If the artist goes in too far, a jelly like layer of the skin is reached and there can be something called pigment migration or in the tattoo dictionary, a “blow out”. When there is too much trauma to the skin it can actually reverse the pigment. This is why he does the areola tattooing in stages as Jess referred to in question 5 in her responses. Kenny prefers this so he can make adjustments based on the client’s preference.
I ask him how he came to know about PRMA and if he knew any of the doctors there. He gave me a couple of answers to that question. First of all he said that he had talked to Dr. Minas Chrysopoulo, one of six skilled micro-surgeons at that office. When I told Kenny that Dr. C was my surgeon this was his response.
Can I just tell you that that man is an artist himself? I am totally amazed when I see work that he has done on patients.
I have to admit I chuckled with pride when he made that statement. Although Kenny has not seen my reconstruction I told him that I completely understood what he was saying and agreed. So for Dr. C to discuss tattooing some of his own patients with Kenny, I view that as a collision of two artists, both working with sharp instruments in their professions to restore what cancer has taken away and both working to create some beautiful work on the canvas of skin!
He also made a connection with Courtney, the PRMA patient liaison, to conduct an educational evening with their monthly meeting for the Pink Ladies Group. Kenny was a guest speaker and discussed his procedure with attendees. This level of outreach has been able to help more women consider this option if they have had their nipples removed during their mastectomy.
Kenny says that this is an evolving profession and he hopes that some of his respected colleagues will help him in elevating tattooing to the art form that he sees it as. He truly feels that there are days when he gets more out of placing this “skin art” on his clients than they do and that speaks a lot for the passion behind his work. I can’t think of clients that would find greater peace of mind, greater satisfaction in Kenny’s work than breast cancer patients.