When most people get a new tattoo, they can't wait to show it off.
That's never been the case for Susan Prince's clients.
Prince is a cosmetic tattoo artist, applying permanent ink to create eyebrows, eyeliner or lip liner. If Prince does her job properly, a woman's features are enhanced to make her lovelier, but no one who looks at her thinks, "Hey, great tattoos."
So Prince was primed to work with breast cancer survivors, giving them tattoos that are not on public view.
She creates areolae and nipples for them.
"It makes them so happy," said Prince, 47, a licensed aesthetician who operates the Center for Permanent Cosmetics in Shakopee. "It's the last step in the journey."
Ten years ago, Prince traveled to New Orleans for a class on fashioning a realistic areola and nipple. Shortly afterward, she began quietly donating her services to breast cancer survivors.
"I call them my finishing touches," said breast cancer survivor Bonnie Clawson, 56, of Bloomington. She came to Prince for tattoos after having a bilateral mastectomy.
Annually, about 250,000 American women get breast cancer diagnoses. With lumpectomies and a new nipple-sparing surgical technique, more of these women can keep their nipples, but many who require mastectomies lose them in the surgery.
According to the American Society of Plastic Surgeons, more than 96,000 survivors had reconstruction after mastectomies in 2011 alone. They have breasts shaped by implants, expanders or transferred tissue. They also can undergo nipple reconstruction surgery that uses a skin graft to re-create the appearance of the areolae. However, nipples fashioned in the operating room lack sensation or function, and some survivors choose to forgo the procedure in favor of tattoos alone.
"Without the tattoos, they were blank. Mounds with scars," said Clawson. "Now, when I see myself in the mirror, I look complete. Susan did that for me. She's really gifted. She's the nipple Picasso."
After working on scores of women, Prince has perfected her areola artistry. She mixes multiple ink shades and uses a technique that adds texture to create an illusion of protrusion.
"It shouldn't look like a stamp," she explained. "We start by placing circles on the chest to see where the nipple should be, how big it should be. We look at shading — peachy, pink, brown, what works with her coloring."
Dr. James Wire, a Chaska plastic surgeon who performs breast reconstruction, has sent a number of his breast cancer patients to Prince because of her technique.
"Susan's a great benefit in their healing," he said. "Reconstruction is stressful and painful. Some of these women have been through so much. The tattoos complete the process, but it isn't another procedure — it doesn't involve surgery or anesthesia or another hospital stay."
Prince says most women who seek her out have already seen her work.
"Most of us who've had breast cancer are glad to share what we know with other women going through it, and that includes showing our results," Clawson said.
Katy Tessman Stanoch met Clawson at a survivor event and got a private peek at Clawson's finished chest. At the time, Stanoch, who had a double mastectomy on her 40th birthday, was still healing after surgery.
"Bonnie had such beautiful work, so I said, 'I'll have what she's having,' " said Stanoch. "The plastic surgeon sculpts you so your silhouette looks good in clothes. The tattoos make me look like myself. A quarter-sized drop of color made a world of difference."
No matter how realistic, the tattoos are only pigment. They do nothing to replace a woman's sensation or function.
"My body is never going to be the same, but now it's closer," said Clawson. "That's all I wanted."
Kevyn Burger is a freelance writer and a newscaster at BringMeTheNews.com.