A close up photograph of a person holding a tattoo gun looking down at the camera.

A Nipple Tattoo: It Can Complete the Look of a Breast After Reconstructive Surgery

  • For most people who get them, tattoos are a form of self-expression. But for some breast cancer survivors, a tattoo can have an entirely different purpose: It can help them love the look of their reconstructed breast after a mastectomy. Often the last step in reconstruction, the art of nipple tattooing is helping women feel whole again on their path to recovery.

    Sometimes a woman’s natural nipple can be preserved during a mastectomy. But when that’s not possible, a remarkably real-looking nipple tattoo can make a powerful and positive difference for those who want a natural look.

    And that’s something Jonathan Bidey, MSN, RN-BC, a registered nurse and newly certified nurse practitioner at Fox Chase Cancer Center, knows about firsthand.

    Since 2013, when Bidey performed his first nipple tattoo at Fox Chase, at least 400 women have turned to him for tattoos after mastectomies. In that time, “Many have told me that before their tattoos they’d avoid looking in the mirror because their breasts seemed so strange without a nipple,” Bidey said. For those who feel that way, “tattooing can help women feel like themselves again.”

    Two tattoo types

    Typically there are two ways to create a new nipple. In some cases, plastic surgeons start the process. They rebuild after reconstructive surgery, typically using tissue from the newly created breast to create a three-dimensional nipple. Later on, color is tattooed onto the newly reconstructed nipple to create an areola—the darker area around the nipple.

    But when the nipple cannot be surgically rebuilt, some women choose to have a nipple tattooed directly on the reconstructed breast. The most realistic results are often achieved with “3-D” tattoos. In this approach, professionals like Bidey use pigment in shades to make a flat tattoo actually look three-dimensional.

    Part artist, part nurse

    This approach takes artistry, which may explain why women frequently exclaim in delight when they see Bidey’s results. He’s a longtime artist—as well as a nurse—who’s painted and drawn since childhood and is a graduate of The Philadelphia High School for the Creative and Performing Arts.

    Four years ago Bidey, who was working as a nurse in ambulatory care at Fox Chase, learned that the Division of Plastic and Reconstructive Surgery wanted to expand its 3-D tattooing so that it would be available to every breast cancer survivor who wanted it. “So I told them I’d like to learn how to do that,” Bidey recalled. “I thought I’d be good at it.”

    Typically, Bidey sees a woman who wants a nipple tattoo twice. In the first session, he talks with the woman about her expectations; customizes the tattoo’s colors, size and placement; and applies the tattoo. Three months later, the woman comes back for a repeat session to help keep the tattoo from fading. In both visits, the actual tattooing is done in an hour or less—it’s that quick.

    “To do this as both an artist and a nurse is so rare—and rewarding,” Bidey said. “I never imagined being able to perfectly blend my love of art with my love of helping people. But that’s exactly what I’m doing.”

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