Restoring your sense of identity
Medical Tattooing can offer a more permanent way to alleviate both private and public appearance concerns, while also improving self-confidence and restoring a sense of identity.
With over 20 years of professional experience, Rae Denman is a qualified Medical Tattooist known internationally for her expertise in reducing the visibility of scarring, as well as recreating a patient’s nipple/areola post-mastectomy and breast reconstruction. Through her work, Rae is making a visible difference in people’s lives, especially those in post-cancer treatment.
Qualitative studies have described a long process of adjustment, involving grief, shame, appearance-related distress, altered identity, and a disrupted work and social life (Davey et al., 2018; Hunt & McHale, 2004; Welsh & Guy, 2009).
“I was diagnosed with colorectal cancer in June 2019 and have been through three rounds of chemotherapy up until early this year.
The type of chemotherapy I have received so far did not mean hair loss and in fact, my eyelashes and eyebrows grow more and rather stunningly curly as a result.
I’ve now had to change to a different regime and the first thing my oncologist told me about it was that I would lose my hair.
For a number of reasons I have received my chemotherapy at home and because I’ve been shielding I have so far felt that my cancer was private and I shared the information with the people I wanted to share it with.
Being confronted with the prospect of losing my hair now has emotionally been one of the hardest things to come to terms with.
I feel suddenly my cancer will be visible to all. And I know it’s not just the hair on my head but all over my body.
It now feels as if I’ll be wearing a great big sign around my neck saying: “I HAVE CANCER”
Hair loss makes the cancer visible to all and I can no longer keep it private. This is a big step for me and one I’m struggling with.”
Positive impact on patients
As a speaker for many cancer care centres and conferences, Rae is working hard to set up referral pathways and multi-disciplinary teams so each patient and consultant are aware of the possibilities surrounding Medical Tattooing treatment and the positive impact it has on patients.
What is Medical Tattooing?
Medical Tattooing is the process of implanting medically certified pigment into the dermal layer of the skin. Topical anaesthetic can be used if necessary and a treatment can last anywhere from 30 mins to 3 hours depending on the size of the area. Generally, 2-4 treatments are needed, leaving 4-10 weeks in between treatments. However, colour boosts are recommended every 1-4 years.
The colour boost is a necessity due to using pigment, rather than ink. Generally, ink is used for normal body tattoos and is a large molecule that stays in the dermal layer of the skin. However, pigment is a much smaller molecule that can travel through the different layers of the skin, be processed, and removed by the lymph system. This means it will fade over time, allowing colours and even the position of the feature to be changed over the years. Combined with camouflage makeup this can further enhance the outcome.
Recently more and more tattooists are offering nipple areola tattooing with ink. Experience with working in the Burns and Plastics Unit at Morriston Hospital (NHS) Rae saw many patients coming in with bright orange or lilac/blue nipple areola that had looked perfect when undertaken by a tattooist. Unfortunately, over time ink breaks down into primary or secondary colours. Many tattooists don’t know or see these results as there is no follow-up with their clients.
Definition, shading, and colour can be added to camouflage an area of scarring or to recreate a lost feature, such as the nipple and areola. By highlighting and shading you can also recreate the illusion of the protrusion of a nipple, necessary as many surgical nipple reconstructions can flatten over time.
Hair loss and losing your identity
We know through research that eyebrows are one of the main concerns for patients even more so than loss of hair from their head. The research Rae carried out with The Centre of Appearance Research states, “Although many participants had adjusted to losing hair from their head, all had experienced the loss of their eyebrows and eyelashes as particularly more distressing. Participants in the research mentioned appearance-related concerns, a loss of self-confidence, and the practicalities of daily upkeep as reasons for seeking a semi-permanent solution.”
The participants in the study saw Medical Tattooing as a more permanent way to alleviate both private and public appearance concerns, while also improving self-confidence and restoring their sense of identity.
A patient quoted from Rae’s research highlights exactly this, by saying, “The eyebrows and eyelashes were worse than losing the hair. Whilst hair loss is massive, I had time to adjust. Your eyebrows give your face definition, and the eyelashes define your femininity. Losing these just felt like my face was empty, and I was devastated.”
Visible differences
Medical Tattooing can add shape and definition by drawing hairs to recreate the brow and adding soft lines to recreate the definition around the eyes.
Scarring and skin grafts are another side effect of oncology-related surgery, often leaving permanent white scarring that can be a constant reminder of the trauma that person has undergone. Medical Tattooing works by colouring in that area of skin to blend it with the surrounding skin tone. The reduction of the visibility of the scarring and grafts can often be the solution for that person. To build their confidence again and reduce their anxiety about constant questions from the public or friends.
Life-changing visible differences such as the nipple/areola complex, eyebrow and hair loss, scarring, and skin grafts; can all arise following cancer treatments. If there are no contraindications, these can all be treated with Medical Tattooing to reduce the visible impact. It is available for men and women, and to date, only the nipple areola tattoo treatment is offered within the NHS.
By way of background, Rae ran the NHS Medical Tattoo clinic in the Burns and Plastics Department of Morriston Hospital, Swansea, working alongside consultants to understand the nature of the different types of surgery involved and how this physically and emotionally impacts patients. She now runs her private clinic on Harley Street.
Rae plans to continue expanding her Medical Tattooing business through research and development so she can provide an innovative, empathetic and world-class service for her patients, including those post-cancer treatment.
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