For many women who undergo reconstruction after a mastectomy, there is no replacement of the breast nipple or areola. That can be a huge loss for women who have been through so much already.
But now, 3D nipple tattooing can produce a remarkably realistic-looking nipple and areola. The procedure was a game-changer for Hannah Brook, who was diagnosed in January 2016 with triple-positive invasive ductal carcinoma.
The 45-year-old mother of two first discovered a lump in her breast a few months after getting her annual mammogram. Still, the Summerlin resident said, “I chose not to pick up the phone and make that call (to her doctor).” Instinctively, she knew that it was breast cancer.
Instead, Brook waited until her next scheduled screening mammogram to get it checked out.
Her treatment, which kicked off with a bilateral mastectomy, included four rounds of the highly toxic chemotherapy medication doxorubicin, better known as “Red Devil.” That was followed by 12 rounds of the hormone therapy medication Tamoxifen, and 14 rounds of the cancer drug Herceptin.
Losing her breasts “was very difficult and it’s very emotional,” said Brook, administrator of the Henderson Chamber of Commerce Foundation. Given the location of her tumor, a nipple-sparing mastectomy was not an option.
“So, not only am I losing my breasts, I am losing any sense of womanhood” that was associated with her nipples, she said. “As a woman, it rattles you, for sure.”
After completing 25 radiation therapy sessions prescribed by her oncologist, Karen Jacks of Comprehensive Cancer Centers of Nevada, Brook was scheduled to undergo breast reconstruction surgery in late October 2017.
The following month, she developed an infection and spent five days in the hospital recovering from a pair of emergency surgeries, during which one of her breast implants was removed.
More than a year later, she underwent an autologous reconstruction surgery with a latissimus dorsi flap. A section of skin, muscle and fat was removed from her back to create a new breast.
As is the case for many women who undergo a mastectomy, neither of Brook’s reconstructed breasts featured a nipple or areola.
She became “very curious” about the art of 3D nipple tattooing. It incorporates special pigmentation and shading techniques different than those used with traditional tattoos elsewhere on the body to create remarkably realistic-looking nipple-areola complexes that appear to protrude from the breast.
Earlier this year, Brook had her breasts inked by Annie Reynolds, a certified paramedical tattoo artist and the owner of Pink Ribbon Tattoo in northwest Las Vegas.
“To me, it’s a game-changer,” Brook said. Tattooing was “the final step that I needed to complete this entire process,” from breast cancer diagnosis and treatment to reconstruction.
“Nipple tattooing can provide breast cancer survivors a feeling of normalcy through an aesthetic procedure,” Dr. Jacks said. “Newer techniques can have very impressive results giving the illusion of a true nipple.”
Reynolds, who graduated from Brigham Young University with a fine arts degree, founded Pink Ribbon Tattoo three and a half years ago. She set up shop in the office of her plastic-surgeon husband, Brandon Reynolds. He frequently performs breast reconstruction surgeries and recognized the lack of high-quality 3D tattooing services available locally for breast cancer survivors.
“I don’t think people realize that it’s needed,” Annie Reynolds said, adding that she is one of a small handful of paramedical tattoo artists in the Las Vegas Valley who specialize in areola repigmentation and nipple creation.
“Most of the time when women get mastectomies, their nipples are removed as well and … they’re left (looking) kind of like Barbies with scars,” Reynolds said. “They just want to feel normal again and how they felt before they had to go through (the cancer treatments and surgeries).”
Reynolds works closely with women (and, oftentimes, their significant others) to determine a proper size, shape and color for one or both nipples and areolas. Surgical scars can also be covered with the tattoos, which she crafts with semi-permanent ink.
“It’s very tricky,” she said. “We sit there and mix up the color and look at it, put a little bit on the skin and see how it plays against the skin tone and say, ‘Maybe a little more pink or brown.’ ”
Each session usually takes Reynolds about an hour per nipple to complete. “We try to make it look as natural as possible with shading, with highlights. … I definitely use my art background to create those illusions and create dimension.”
She has clients return to her office six to eight weeks after their initial tattooing session, once the resulting skin redness and irritation have subsided, so that she can inspect her work and add color or shading, if necessary. Because semi-permanent ink fades over time, most patients require more extensive touch-ups to their tattoos within five to 10 years.
“I’ve had people cry on my table, just so relieved that this is the end (of their cancer journey),” Reynolds said. “They just feel whole again.”
Brook said her tattoos, which took three sessions for Reynolds to complete, have helped her feel “more complete. I’m definitely not 100 percent of what I was before, because I’m riddled with scars, but I have a similar shape to what I was before. I don’t feel like I’m missing anything.”