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  • Writer's pictureTerry Lively

Areola Restorative Tattooing - Working With Warriors

Updated: Apr 6, 2018

As a medical tattooer with almost 20 years in the tattoo industry, I am constantly amazed at the warriors who walk through my door. Many times we call breast cancer patients survivors, however I prefer to call them "warriors". Why do I feel that way?

I hear their stories. When tattooing someone in such an intimate setting, you develop an immediate bond. At first, it may be casual talk about their children, their work, their dog..... and then you hear their story. I've always said that everyone has a story, we just have to take the time to listen. A two hour appointment with a breast cancer warrior gives you that time to listen. Much like a soldier who has gone through dramatic and stressful situations on the battlefield, some of the breast cancer warriors have been through hell and back

Many of these warriors have had serious problems related to the mastectomy or reconstruction. Some have had numerous surgeries due to complications such as necrosis of tissue that has been transplanted from the abdomen to the breast in procedures such as DIEP flap. This requires more surgery, more healing, etc. Another problem, although less serious, is uneven results of bilateral reconstruction. Sometimes one side is higher than the other. This is not to take away from the work of the surgeons. Many times they are working on very complicated cases. They are artists too, and I am constantly amazed at what they create during reconstruction. Still at times, things aren't perfect, for one reason or another. Here is a photo of a recent case such as this:

Before areola nipple tattoo
Before areola nipple tattooing

Scars from breast reconstruction
Scars from breast reconstruction

Usually there are scars. Sometimes a LOT of scars. Each case is different. Some scars can be smoothed out and flattened through tattooing. Some scars can be made less apparent through camouflage tattooing.

Scarring from breast reconstruction
Scarring from breast reconstruction

As a tattooer, it is my goal to draw attention away from scars, asymmetry from uneven work, and other similar issues. It's my job to make this warrior feel at peace again, and to take her away from the battlefield.

Here are a few photos of photorealistic tattooing that I have performed. I'm proud of my work. I like to think of myself as a friend, and a healer for these warriors. The first picture below is work I did on the client with uneven nipples and one breast lower than the other. I was unable to reposition the tattoos because of the creation of the nipples by the surgeon:

This photo shows scarring, and how artistic tattooing can draw the eye away.

Photo realism nipple tattoo by Terry Lively
Photo realistic nipple tattooing by Terry Lively

Another issue we deal with is the warrior with radiated skin. This skin is fragile and challenging to tattoo. It takes a skilled tattooer to understand how to adjust their equipment for this type of skin. It takes years of tattooing daily, to achieve this skill level.

In conclusion, if you are a warrior looking for a skilled tattoo artist to complete your journey, do your research. Make sure the artist has years of experience and photos to prove it. Ask for references. Some physicians offer tattooing services in their clinics. At times they have skilled tattoo artists come in to offer this service. Other times, it is being done by nurses or CMA's with no background in tattooing, no artistic skills, and no real experience with suitable equipment. Please choose your artist wisely. As a warrior, you have a choice as to who you want on the battlefield with you.

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Krizzy Macali
Krizzy Macali
Jul 19, 2022

Are areola tattoos permanent? Breast reconstruction surgery, often known as a mastectomy, can be triggering, dysmorphic, or otherwise distressing for breast cancer survivors. For individuals who desire it, an areola tattoo can be obtained, which reconstructs the appearance of your nipple using color to make it appear more natural and realistic. Certain survivors are even thinking of getting some designs tattooed. My buddy, who has been through similar life experiences, has a permanent one and acquired his design from

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