Doctor helps raise breast cancer survivors' self-esteem with restorative tattooing

Restorative tattooing is a procedure that lets breast cancer survivors revive their self-esteem and self-image, according to Dr. Linda Dixon, president of the American Academy of Micropigmentation and owner of Wakeup with Makeup, a cosmetic tattooing practice in Hawaii. 

“I call it the final step in the fight. It’s the one step that gives women back their dignity and it makes them feel whole,” Dixon said. 

The procedure for breast cancer survivors involves tattooing areolas and nipples on women who have had mastectomies or other breast surgeries. 

Restorative areola tattoos helps clients feel less self-conscious about their breasts, in part because of the added color, Dixon said. 

“If you see a breast without an areola and a nipple, without that color ... there’s just these two mounds,” she said. 

Dixon said she began practicing permanent makeup in 1995, when no one was teaching how to tattoo areolas naturally. She said she learned by asking around her professional network and doing some research.  

“I just started researching natural colors. One thing that helped me a lot was if they had one breast remaining so at least I had something to compare with for color and for size,” she said. 

Dixon says she uses a digital tattooing gun, but the procedure can be performed using a hand-tool as well. 

“Sometimes the skin is really fragile. It’s very delicate and some ... have gone through radiation, others have the implants right there ... you want to just be sure to protect the skin,” Dixon said. 

Areola tattooing is an artistic thing, Dixon said.

 “I ... went to a local tattoo artist who I made friends with 16, 17 years ago and I said, ‘Hey Jim, let’s draw areolas and nipples,’” Dixon said. 

“We started drawing ... coloring them in, different layers of color. You sort of layer the color and then you want to see how they heal,” Dixon said. 

Layering, highlighting and shading are techniques Dixon uses to achieve a 3-D look.

“You want to highlight the nipple because light hits from the top down and then you shadow it underneath,” she said. 

Dixon said she has always provided her restorative tattooing services at no charge. 

“It’s my way of giving back. These women have been through a very difficult time in their life. A lot of them are depressed and they have a poor body image now. ... I would be uncomfortable charging them,” she said. 

Dixon said she wanted to find a way to let people know about the free services, so she created the Survivor Academy Action Volunteer Effort (SAAVE) with the American Academy of Micropigmentation. 

“The Academy just said, ‘Hey, if you are willing or if you’re available to do these at no charge, then let us know and we’ll post you on our website,’” Dixon said.  

Providing these services is a rewarding experience, Dixon said. 

“These women, ... they are overjoyed. ... They’ve been through chemotherapy, they’ve been through surgery, they’ve been through reconstruction. A lot of them have been through radiation. ... Finally they have a bright spot,” Dixon said. 

“I guess you could call us the light at the end of the tunnel,” she added. 

You can see the list of SAAVE participants here.