Tattoos Help Breast Cancer Patients Heal After Mastectomy

Fran Lowry

February 21, 2017

David Allen, Chicago-based artist and tattooer, is helping women who have had mastectomies transform their sense of disfigurement by drawing beautiful images over their mastectomy scars.

On a good day, he says, he can heal with his art.

Allen describes his work in the Arts and Medicine section of the February 21 issue of JAMA.

At first he was reluctant to tattoo radiated skin. But a persistent client eventually got him to try.


"My first client had had a single mastectomy, and she thought I would be really good at giving her a floral tattoo over her reconstruction. I was hesitant to do so because I was scared to go over the radiated skin, and I told her no. She stayed on me for 6 months. So I did some research and agreed to try. I was meticulous and careful, and it turned out to be the most incredible experience. It was overwhelming for both of us, transformative. It was beautiful. It's rare that you get to use your craft to help somebody, to contribute in that way," Allen told Medscape Medical News.

A painter, Allen became a tattooer 10 years ago, after his son was born.

"I was an art director for a music magazine. It was a desk job. My dad died when I was 6, so I didn't have a dad, and when my son was born, I wanted to be around him. So I thought, what job could I do that would still be lucrative and allow me to make my own hours if I am successful? With tattooing, I make my own hours, and it's wonderful. It was a drastic change in career, but I made it work," he said.

Allen created his first postmastectomy tattoo 5 years ago. He has done about 70 to date, and is in demand to do more. He credits the Internet for making him known.

"I tattoo in Chicago, but 95% of my clients fly in from all over the world. Women find out about me by the Internet, and a few of my tattoos have gone viral. There was also a Chicago Tribune article that was supposed to be in the back of the paper, but the women who did the article put so much love into it, and the great photos, so the Tribune put it on the front page, so it really blew up. Now there is a queue of women, and there is only one of me, so I'm trying to get through it," Allen said.

Women who do contact him for postmastectomy tattoos are asked hundreds of questions before he agrees to take them on.

"I need to know that they're ready. My contribution needs to be a healthy, organic part of their path through their illness. I'll decline to do the work if I get the sense that this is not the case," he said.

Creating a work of art on a woman's body after she has gone through the ordeal of losing a breast gives her a sense of control over an unexpected, disturbing, and sudden event, Allen said.

"I think they can reclaim some sense of control. These women with whom I work feel that they have been acted upon by forces beyond their control, but with this art, they can reclaim a new point of reference. It's not how it was before, we are not just simulating what was there. We're actually creating their own work of art that fits their scarring, that conceals what they don't like about the process of their treatments. They are part of the creation. They are part of the designing, and they can own it," he said.

Tattoos after mastectomy can help with healing, says artist.

Allen acknowledges that the artwork is important. But perhaps more important is the time he spends with his clients.

"I'm finding that even more crucial is the time you spend with these ladies, not tattooing but getting to know them beforehand and then spending time talking and hearing their stories and learning who they are so they feel comfortable enough to be themselves around you. Then you get to see what they would like because they trust you," he said.

Allen has developed an approach that differs from that of other artists, plastic surgeons, and micropigmentationists.

"A standard approach to postmastectomy micropigmentation is to tattoo images of a nipple on a breast mound or reconstructed breast. To my eye, a clinical trompe l'oeil image of a tattooed nipple lacks character. It has no relationship to the woman's altered body and mind. The women I see want the opportunity to turn themselves into something that transcends an imitation of what they used to look like," he said. "As I've done this work, I have evolved toward botanical imagery – branches, stems, leaves, flowers -- as the most effective way to transform the surgically altered breast."

Empathy is crucial to doing this work, Allen said.

"Empathy, care, and a thoughtful reading of the patient is more important for a successful outcome than the procedural aspects of tattooing," he said.

He often is invited to speak about empathy. His most recent talk was at Drexel University in Philadelphia.

"Empathy is just being present and not just resonating. For example, if you were to start crying right now on the phone and I were to cry with you, I would be resonating. But I don't know why you are crying. Empathy is finding the context, it's learning from you and being present and then using my imagination to understand how you feel. I am using empathy to my client's plight. They have gone through this terrible ordeal," Allen said.

JAMA. 2017;317:672-674. Full text


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