The first time a breast cancer survivor asked David Allen to tattoo her chest, he refused. He knew the skin had gone through a lot during the surgery to remove the breasts, called a mastectomy, and he was hesitant about using needles on such a sensitive area. But the woman stayed on him for six months, until he finally caved.
“It was transformative,” Allen, a tattoo artist in Chicago, tells The Verge. “It was pretty overwhelming.” The woman started weeping after the tattoo was complete, and Allen was moved, too. “There was a change, a transformation afterwards that we didn’t expect,” Allen says. “It’s not often that you get to use your art to help, to transform someone.”
That was about a decade ago. Since then, Allen has refined his technique, and used his tattoos to transform a sense of disfigurement a lot of women feel into feelings of beauty. Tattooing images of plants and flowers over the scars also help women feel like they’re taking control of their bodies again, Allen says. He wrote about his experience with cancer patients in an essay published today in the journal JAMA.
Women who undergo mastectomies can choose to have their breasts reconstructed — a procedure that’s often covered by health insurances — or go flat. These breast reconstructions, however, often lack nipples, so some women choose to have the nipples tattooed on their new breasts. (This procedure is also often covered by insurance.) Other women opt to get more artistic tattoos all over their chests to cover up the scars — a trend that’s been gaining momentum in the past few years, as social media provide a platform for breast cancer survivors to communicate and share their stories.
Allen says that he screens women before agreeing to work with them. He asks hundreds of questions in lengthy phone conversations. He wants to understand why they want a tattoo, how they’re feeling about it, and whether they’re ready. One woman began crying when he touched her, because her husband had left her after her illness and she hadn’t been touched by a man in years. “That wasn’t the time for me to begin my work,” Allen writes.
Even when he agrees to do a tattoo, which takes two to three hours, Allen spends the entire day with his clients before getting to work. He gets to know them, hears their stories, reviews their medical records, and designs the tattoos in front of them. “Empathy is just as important to me as the actual application of the tattoo,” Allen says. “The talking and hanging out takes more time than the actual tattoo.”
He tattoos old botanical illustrations by Pierre-Joseph Redouté, a French botanical painter who lived from 1759 to 1840. Tattoos of branches, stems, leaves, and flowers are great because they can be easily adjusted if the women have to get surgery again. Images of animals can get easily distorted and become unrecognizable, he says. He also needs to be very gentle when applying the ink, using three needles instead of the usual five to nine. After radiation and a mastectomy, the chest skin has gone through a lot, and many women are particularly sensitive in the area. “I just have to err on the side of caution,” Allen says.
The results have always been good for now, Allen says. He’s never gotten a complaint, and he has received the support of his clients’ surgeons. How the women react to the tattoos obviously vary from person to person: some are proud of the tattoo and want to show it to the world; others “feel resexualized” and become more confident. What’s clear to Allen is that the tattoos can help the women heal. “I want these women to be able to take some semblance of control back — and this is doing that,” he says. “There’s healing in art.”
For now, however, health insurances aren’t covering the costs of the tattoos, which range between $1,000 to $2,000, Allen says. He’s working with a plastic surgeon in Minneapolis to introduce the option to breast cancer patients who’ve undergone mastectomies. And he’s hoping that, in the future, tattoos will just be considered on the same level of breast reconstructions and tattooed nipples.
The tide might be starting to change. After being featured in a front-page article in the Chicago Tribune, Allen was contacted by JAMA to write his essay. Writing about his experience — and that of his clients — in a prestigious medical journal was really important to Allen. “I’m very happy. I think it validates a lot,” he says. “I think that conversation needs to happen.”
Below you can see some more photos of Allen’s work.