Decorative tattoos after breast cancer surgery

Some people consider having a decorative tattoo on their breast or chest after breast cancer surgery.

This is sometimes referred to as a “mastectomy tattoo”, but could be done after breast-conserving surgery, a mastectomy or breast reconstruction.

Nipple and areola tattoos

Decorative tattoos are different from nipple and areola tattoos which aim to create a natural-looking nipple on the skin.

Nipple and areola tattoos are usually carried out by a doctor or nurse with specialist training, although some tattoo artists specialise in this type of tattooing too.

If you’d like to find out more about nipple and areola tattoos, speak to your treatment team. You can also read our information about nipple and areola tattooing.

Why get a tattoo?

You may consider having a decorative tattoo for a variety of reasons, including to:

• Help you feel more confident after breast cancer treatment
• Mark what you have been through and create something personal
• Cover or disguise a scar

When can I get a tattoo?

Before getting a tattoo, your scars need to be completely healed. This takes around 1 year, but ideally you should leave it longer before getting a tattoo.

You should have also finished and recovered from any chemotherapy or radiotherapy treatment.

Check with your treatment team if you’re considering getting a tattoo.

Where should I go to get a tattoo?

It’s important to find an artist you feel confident and comfortable with, who has experience in mastectomy and scar tattooing and who understands what you’d like to achieve.

The Mastectomy Tattooing Alliance has a list of recommended UK-based tattoo artists with experience of mastectomy tattoos. It also provides funding to its approved artists to help make tattoos more accessible and affordable to people affected by breast cancer.

If you know anybody who has a tattoo, ask them where and how it was done and if they’re happy with the result.

It’s a good idea to visit a few tattoo studios and have a consultation with the artists. That way you can get an idea of what’s involved, how each artist works, how clean their studio is and whether they’ll be able to create something you want.

What to ask your tattoo artist

Here are some questions you may want to ask your tattoo artist:

• Do you have any examples of mastectomy tattoos that I can see pictures of?
• Have you worked with people who have had treatment for breast cancer before?
• Do you have experience of tattooing around scars?
• Could I have my tattoo done in a private room?
• Can I bring a friend or family member with me for support?
• How long will my tattoo take and will I need multiple sessions?
• Can I see the design before starting the tattoo to make sure I’m happy with it?

Check that the person who is doing the tattoo is registered and has an up-to-date health and safety certificate. Anyone who carries out tattooing should be registered with their local authority. You can contact your local authority to check this. Their license should also be displayed in their tattoo studio.

The tattoo artist should ask you some health questions, including asking about any allergies or any health conditions you might have.

Make sure you tell your tattoo artist about any medication you’re taking.

What happens when you get a tattoo?

You may need several sessions to complete the tattoo.

Most tattoo artists will incorporate any surgical scar into the design and shape of the tattoo, rather than actually inject ink into it. However, it’s sometimes possible to inject ink directly into the scar.

Scars vary from person to person and depend on the type of surgery you’ve had. This means that some designs will work better than others on different people. Your tattoo artist should be able to advise you on what would work best for you.

They should also make sure you have all the necessary aftercare advice and instructions to care for your tattoo.

You won’t be given any local anaesthetic during the tattooing process, so you may find it painful. How painful it is can vary a lot from person to person.

If you’re worried about pain, talk to your tattoo artist about this as they might be able to give you some tips.

Infection

Tattoo artists should always use sterile equipment and fresh needles to reduce the risk of infection.

If any redness or swelling doesn’t go away or seems to be getting worse, and you develop a high temperature or feel feverish, you may have an infection.

If you think you have an infection contact your GP, nearest urgent care centre or A&E as soon as possible as you may need antibiotics.

Other risks

Other risks include:

• Allergy to pigment – this is very rare, but some studios offer a patch test before a tattoo
• The colour (pigment) fading – the pigment will naturally fade over time. To reduce initial fading avoid swimming, sunbathing, using a sunbed or doing exercise that makes you sweat for 2 weeks after having a tattoo. You can use a high factor sunscreen on your tattoo to help reduce fading
• Changing your mind – it’s possible to get tattoos removed but it’s expensive and can be very painful. There’s also no guarantee that a tattoo can be completely removed

The tattooed area will be swollen and red, and may be itchy, dry or flaky, but this should go away over time. Redness can be harder to see if you have black or brown skin. You may also have some bruising to the area.

If you’re concerned about the risks of getting a tattoo or are worried about how your tattoo is healing, talk to your tattoo artist, treatment team or GP.

Can tattoos cause lymphoedema?

There’s limited evidence that having a tattoo on your breast, chest or arm on the side of your surgery increases the risk of developing lymphoedema in that area.

You might be more at risk of developing lymphoedema if you get an infection following your tattoo.

Always check with your treatment team if you’re considering getting a tattoo and are concerned about lymphoedema. They’ll help you weigh up the risks and benefits so you can come to a decision that’s right for you.

If you already have lymphoedema, speak to your treatment team before having a tattoo. They’ll be able to advise you on the risks based on your individual situation.

Aftercare

Your tattoo artist should give you information about how to look after your tattoo.

It’s important to always wash and dry your hands before touching the area to reduce the risk of infection. Your tattoo may be covered with a non-stick dressing, and you’ll be told how long to keep this on for.

A tattoo covering a large area may have plastic film wrap applied and you should be told when to replace this. You’ll be advised to keep the area clean and dry. Sometimes the tattoo artist will recommend applying cream to your tattoo. They can suggest which products to use and where you can get them from.

While the tattoo is healing you may not be able to wear a bra and may prefer to wear loose natural fabrics. This might be necessary for around 3 weeks.

Having an MRI after a tattoo

An MRI (magnetic resonance imaging) is a type of scan that uses magnetism and radio waves to produce a series of images of the inside of the body. It can affect any metal or metal fragments in your body.

If you need an MRI, tell the radiographer you have a tattoo. This is because some tattoo inks contain traces of metal. However, most tattoos are safe in the scanner.

If you feel any heat or discomfort in your tattoo area while having an MRI, tell the radiographer.

There are plenty of images online that might give you some inspiration. You could also look at the websites or social media pages of local tattoo artists to get some design ideas.

Personal Ink (P.Ink) has a gallery of images that may give you some inspiration.

The Mastectomy Tattooing Alliance also has some examples on their website.

You could also have a look at our online forum and see if anyone has had a tattoo and where they had it done, or start your own thread.

The examples below may also help you think about what designs could work for you.