"Cool." Anja D. reacts with this word and an almost reverent silence when she sees her new nipple in the mirror for the first time. From a distance you can't tell that the left nipple isn't real. It's not even plastic, just two-dimensional. A tattoo.
Anja D. had breast cancer in 2021. An aggressive form, as she tells it. Chemotherapy followed and the breast was removed. Last year, the 57-year-old woman from Aichach in Swabia had a new breast formed from her belly fat. But she hasn't really felt comfortable yet. "I never used to have any problems with nudity, but now I'm often ashamed," says the office clerk. The new nipple is supposed to be the end of a story of suffering. "I hope to be able to put a twist on the story."
For Anja D., the wart is not just “the cherry on the cake,” as she herself says, but rather it completes the self again. Anja D. is a lively and committed woman. She rides a Harley, used to model, and also talks vividly about difficult times in her life. However, when she sees the tattoo for the first time, she suddenly becomes calm and relaxed. "Now it finally looks the same again. That's good," she says with a slight sigh.
International research results
According to a review by Italian researchers, nipple reconstruction is an essential part of breast reconstruction from the perspective of cancer patients. Complications with tattoos are relatively rare. “Patients with nipple reconstruction have higher overall and aesthetic satisfaction,” the authors write. Korean scientists found in a study that patients are particularly satisfied with nipple tattoos. According to Australian researchers, satisfaction persists even years later.
The tattoos are sometimes done by doctors and sometimes by tattoo artists. Anja D. had her tattoo done by tattoo artist Andy Engel in Marktsteft, Lower Franconia (Kitzingen district). "I had read stories online about women who had been to doctors who rarely tattooed. Some of that had nothing to do with natural nipples," says Anja D. For example, the color was more gray. That's why she wanted someone who really knew about tattoos.
An artificial wart made by an artist
Engel's tattoo studio is comfortably furnished and decorated for winter. On the walls, painted in a warm dark red, hang photos and pictures of angels with rock musicians, Bud Spencer, and family members. The piercing took a good half hour. The whole treatment takes two to three hours. First, Engel took a photo of the still healthy nipple and used it to create a template for the artificial wart.
Engel and a colleague say they pierce around 200 to 250 nipples a year. “The idea for this came from a customer in 2008,” says Engel. The 51-year-old is actually known for photorealistic portraits of people and animals. According to him, customers have to wait several years for an appointment. But he prefers cancer patients.
Engel developed special colors for nipple reconstruction and observed breast operations. Several tattoo artists across Germany as well as in Austria and Switzerland now work according to his principle. After the tattoo appointment, women can come back for one and a half years. “That’s about how long it takes until you can fully see how the colors work,” says Engel.
Not all health insurance companies cover the costs
Anja D.'s health insurance company paid the almost 2,000 euros. According to the tattoo studio, 60 percent of health insurance companies cover the costs in full, 20 percent partially, and 20 not at all. Anja D. changed the cash register especially for the tattoo. She is very annoyed that her previous cash register fell on deaf ears. “Breast cancer is not a walk in the garden,” she says. In addition to the physical problems, the medical system put a lot of strain on her. She often met people who already seemed jaded to her. “Then having to fight for the tattoo at the end, even though the treatment previously cost so much - I don’t understand that,” says the 57-year-old.
Tattoos are more than art on your own body
By the way, the nipple is Anja D.'s second tattoo. The engine of a Harley Davidson adorns her upper arm. Tattoos in general often not only have an aesthetic effect, but usually also a psychological one. Especially with cancer patients. A tattoo can be a step towards regaining control over your own body and your own life story, as the scientist Kristin Langellier writes in a book chapter called "You're marked - Breast cancer, tattoo, and the narrative performance of identity". .
According to studies, tattoos in general can make it easier to cope with difficult phases of life, such as after the death of a loved one or after abuse. Accordingly, tattoos can help you deal with a traumatic experience and incorporate it into your own life story.
Nipple tattoos are among the so-called medical tattoos. They are not only used after breast cancer, but also for trans women. Another form of medical tattoos is to cover scars. For example, scars after breast surgery can be decorated with flower tendrils. Engel also tattoos penises of trans men (called penoids) to give them the correct body color.
A few days after the tattoo appointment, Anja D. is satisfied with the work of art on her skin. “I’m so glad I did it,” she says.