Mastectomy Tattoos Offer New Beginning

By Colleen Schrappen St. Louis Post-Dispatch

WWR Article Summary (tl;dr) As more cancer patients do their own research and become better informed about post-surgery options, a growing number of women are opting for mastectomy tattoos after breast cancer surgery.

St. Louis Post-Dispatch

Kerry Soraci's recent tattoo client did not come to Iron Age Studios to get trendy body art. No Bible verse scrolled across the rib cage or Japanese symbol inked on the ankle.

In fact, until a few weeks ago, the 66-year-old grandmother never thought she would get a tattoo, much less one that stretched across her breast. But the cancer survivor decided four years after her diagnosis and two years after breast reconstruction that she was ready to quit undressing in the dark.

Soraci, 49, first tattooed a mastectomy patient more than 20 years ago. Several years ago, the demand started to grow. Now she works with three or four survivors a month.

That increase is due, in part, to cancer patients doing their own research and becoming better informed about post-surgery options, said Dr. Theresa Schwartz, a breast surgeon who works out of St. Louis University Hospital.

And though the incidences of invasive breast cancer have stabilized in the past few years -- about 247,000 new cases are expected to be diagnosed in the United States in 2016 -- mastectomies are on the rise.

According to the American Cancer Society, more than a third of women with early-stage breast cancer opt to have a mastectomy. And the number of women who choose to have a healthy breast removed as a preventive measure has tripled in the past decade.

After a patient has healed from the surgery, Schwartz said, she can remain flat-chested or undergo breast reconstruction.

Then, if the nipple and areola have been removed, the woman can decide whether she wants to get a tattoo to mimic the look. Or she may prefer something artistic to create a new appearance.

"It's the one thing they have control over after 18 months of treatment," Schwartz said. Knowing about the possibility of post-op tattoos helps relieve a patient's anxiety, she said.

Some plastic surgeons offer a skin coloring procedure, but their tools and pigments are limited. The nipple area can turn out looking like a flat, monochromatic disk. And the color may fade over time.

Soraci can blend an infinite combination of pinks and browns to complement skin tone, and use shading and highlights to create a three-dimensional illusion.

"Plastic surgeons are not graphic artists," Schwartz said. "And they can't do anything different," like a cascade of ivy or a blooming sunflower. "The tattoos are a means of self-expression. It's realizing you have a new beginning once you're done with treatment."

So Schwartz sends her patients to Soraci, whom the doctor found out about a couple of years ago from a patient who had previously been tattooed by the artist.

A nurturing hand Soraci, who has a degree in fine arts from Washington University, finds fulfillment helping women figure out how they want to look and feel in their new bodies.

"After all the medical treatment," she said, "a nurturing hand is nice."

She makes appointments for her mastectomy patients in the morning, before the Delmar Loop studio is officially open. It's quiet and private. The tattoo stalls are empty.

Soraci takes her time with the women, describing what she is doing and why, asking them about preferences, and explaining how the tattoo will soften their scars, and maybe, the constant reminder of their disease.

The grandmother who met with Soraci on a recent morning was intrigued about changing her appearance. "You don't want to see your (scarred) chest. You certainly don't look like you used to," she said of the removal and reconstruction of her left breast. "Nothing matches. I was really shocked that it looked pretty bad."

Even as she did some online research, however, she thought, "I'm 66. Who cares what I look like? But then I finally decided, I care. I want to like the way I look."

Still, second thoughts had almost spurred her to cancel her appointment. "But after the breast cancer, this seems like minor stuff," said the Collinsville resident, who did not want her name used because she hadn't told her children of her foray into body art. The pain is typically less than with other tattoos; after surgery, the breast area usually has diminished sensitivity.

At the front counter of the tattoo parlor in the Delmar Loop, she pulls out her phone and shows Soraci a picture of a cluster of flowers with a butterfly hovering on the side. Soraci takes her into a small room and examines her. Then Soraci disappears into a back office where she will draw the image, sizing it to fit a template that has been shaped and folded to match the woman's curves.

A long journey "Post-mastectomy tattoos encompass the true nature of tattooing," said Soraci. "They mark a real rite of passage, a celebration to an end of a very traumatic journey."

Linda Leah of St. Peters has been on this journey twice. Leah, 51, was first diagnosed with cancer 30 years ago, in her thyroid.

Last fall, a routine mammogram led to a biopsy that found two types of cancer. She underwent a double mastectomy in February. In the prep room, her doctor talked about her nipples for the first time.

If a tumor is found within 2 centimeters of a woman's nipples, removal is recommended; 4 centimeters away is considered a safe zone. Leah's was within 3.

"I had them removed," she said. "I didn't want to go through this again. I didn't want any breast tissue left, didn't want it at the back of my mind."

After reconstruction in February, she found the way she looked unsettling. Her surgeon said he could tattoo her breasts and her insurance would cover it, but he recommended Soraci, even though it meant paying out of pocket.

For Leah, it was worth the $250. Before her breasts had healed enough to get nipples inked on, she opted for a design of black curlicues encircling the sides of her chest. In May, she returned to Soraci to finalize her transformation.

"I was amazed at how good the nipples looked," Leah said. "At least when I look in the mirror, they are more normal. The scars are still there, but it doesn't make you look at them so much."

To feel complete It's close to noon when Soraci finishes up with the Collinsville grandmother at Iron Age.

The pale scar that had bisected her left breast like an equator is barely visible, covered now with blush, coral and magenta petals. Soraci reminds her how to care for the tattoo as it heals, and the woman takes just a passing glance in the mirror before she dresses and leaves.

Later, at home, she gives herself time to take in her new appearance.

"It turned out really pretty. I'm very glad I did it," she said. "It was so worth it."

That's the reaction Melissa McHale of St. Peters also anticipated in making her appointment with Soraci. McHale, 34, is not new to getting inked. Her nipples mark her sixth and seventh tattoos.

But after a stage 4 cancer diagnosis, two years of chemotherapy, surgeries and radiation, she expects these will bring a sense of relief.

"After every step that I've been through, this is the end of my journey," McHale said. "Everything has worked up to this: It's the light at the end of the tunnel.

"I think I'm just going to feel complete."

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