The road to recovery following a breast cancer diagnosis is a lengthy one.
After undergoing chemotherapy, radiation and surgeries, breast cancer patients are often left with scars that can impact their physical, emotional and mental well-being — even after the cancer is long gone.
That’s why having access to a safe and qualified paramedical tattoo professional is so important, says Daria Montague, a certified paramedical tattoo artist and owner of Healing Arts Micro-Pigmentation & Wellness Centre in Barrie.
Currently, such procedures, which include creating realistic areola tattoos for people who have undergone mastectomies, is not covered by OHIP (the government-run health plan for Ontario) unless it’s performed by a physician. Unfortunately, the wait list for that can be years long, she explained.
“RVH had a three-year-long list, and that’s how this came to me. We were talking to doctors and surgeons, and someone needed to do it,” said Montague. “There are people who don’t have three years. I have clients who are terminal. I had one client say that she wasn’t going to die without her boobs, so I gave (her) some dignity and let them look great.”
The procedure to create 3D nipple/areola micropigmentation should be “part of the package” for women who have undergone mastectomies and breast reconstruction surgeries and who are looking to restore a sense of “symmetry and completeness” to the breast area, said Montague. Much like fingerprints, no cancer journey — or nipple — is the same, she added.
Not your regular tattoo
In addition to using a special type of ink, Montague said there is a lot more that goes into a paramedical tattoo.
“There are measurements involved. The longest part of the process is getting the colour right. When you’re laying there, your eyes are closed and I am looking at your lids and your lips and trying to collect your natural pigment, and that’s what I use for the base,” she said.
“Micropigmentation is not just implanting ink under the skin. I am the last person a woman sees. They’ve gone through the process of chemo, radiation, surgeries and, often, multiple reconstruction surgeries. When they are done, I put those cherries on top of the cake. I fix the girls. It’s a mental help.
“This procedure must be part of your recovery. (Many women) want to look like they did before and not necessarily look at those scars.”
An emotional journey
Diane Jackson, 55, is one of those women, having been diagnosed with breast cancer in 2016. With a long history of breast cancer in her family, Jackson spent 20 years as part of an early hereditary breast cancer study at Sunnybrook Health Sciences Centre in Toronto, and said just as she was about to be released from the study, cancer was detected.
She was ultimately diagnosed with invasive lobular carcinoma in the left breast and she opted to undergo a double mastectomy.
Jackson underwent reconstruction surgery but said radiation had done so much damage to her skin, she could not also have nipple reconstruction, and was left with only one other option — a tattoo — but the wait list was extensive.
“Our lovely health-care system will only pay a set amount and only if the hospital does it. Surgeons are lovely at what they do, but they are not artists. You don’t have to pay for it … but it’s not a work of art,” she said.
Jackson said the procedure with Montague took a few hours, with the final result leaving her in tears.
“When I stood up, I just buckled to see something normal for a change. It was unbelievable,” she said while holding back tears. “It looked so natural that I was at my plastic surgeon's last week and, when I opened my gown, (their) jaws just dropped.”
While Jackson acknowledged the procedure is not something every breast cancer survivor will want, for her, it served as an important part in her post-cancer journey.
“A good reconstruction means you look normal in clothes. When you take your clothes off and look in the mirror, your body has forever changed. Sometimes there are these little things, like having a really good tattoo, that just make it a little bit easier so every time you look in the mirror, you’re not seeing the big scar. When you have nipples, you don’t really notice all of those imperfections as much. Your eyes just go to them,” she said.
A natural transition to help women
Montague, who opened her clinic in one of the medical buildings at Quarry Ridge this past spring, has been performing paramedical tattoos for clients for about five years, noting her foray into paramedical tattooing came quite organically after a client at her Cedar Point tattoo studio asked her if she could show her scars.
“I had no idea there was such a need. She showed me herself and then I started wondering, ‘What could I do?’ I started researching and found a place that I could go and learn because it’s a very narrow specialty and you’re working on skin that’s been through surgeries, radiation, chemotherapy,” she said.
A call for change
Jackson called Montague her “guardian angel,” saying the work she did changed how she felt about herself, adding Montague spent more time matching skin tones than it took to do the tattoo to make it look as natural as possible.
“If you have someone who is not that experienced, they will do that perfect circle, almost like a pepperoni. With mine, the imperfections of it makes it perfect,” she said. “I am on the green side of sod, so I am happy to be here, but you don’t realize how much (of a toll) emotionally it takes on you. When I did the tattoos and now I lift my shirt up, I look like I used to look.”
With few physicians currently available to perform the procedure, Kennedy hopes OHIP will reconsider its position and allow coverage for work done by qualified and certified paramedical tattooers.
“I am not sure what other process would be considered complete half-done. They cover the reconstruction, and we are very lucky we live in a country where that’s the case, but a reconstruction is not done when you’re left with just a breast and a big scar that goes through,” she said. “It’s a lump on your chest. That nipple is what makes it complete, and I am not sure why they don’t want to complete the process.”
