After hearing that she had the most common form of breast cancer at age 39, Stephanie Sharp pointedly asked her doctor if she would lose her breasts.

“People don’t realize how important having a nipple is to feeling feminine and like a woman,” she recalls. “And most women don’t know what kind of options there are for reconstruction until they have to know—when they are diagnosed.”

Today more women diagnosed with breast cancer elect to undergo a mastectomy procedure to fully remove their breast to treat the cancer. The American Cancer Society estimates that anywhere from 20 percent to 40 percent of women who chose to surgically remove their breasts also have some form of reconstruction.

For many women undergoing this process, the last step after leaving the operating room is a stop at a tattoo parlor.

Following her breast cancer diagnosis in early 2011, Sharp kept a blog chronicling her almost yearlong journey through cancer treatments, including eight rounds of chemotherapy, radiation and reconstruction. In her last post, she wrote about getting a tattoo as the final step of her reconstruction process, almost three and a half years after her mastectomy.

Healing With Ink

Ron Hendon’s chair at Midnight Iguana Tattoo in Athens, Ga. is no stranger to seating breast cancer survivors. Using the same machine and ink he uses to tattoo a skull or dragon design, Hendon is able to create a realistic-looking nipple on women who have lost theirs as a result of a mastectomy.  

The medical term for the procedure is Micro-pigment Implantation, which means recoloring skin with flesh tone-colored ink to replace lost pigment. Traditionally, the same plastic surgeon that performed the breast reconstruction pickd up a tattoo machine and addd color to the areolas he or she had just created. This practice is changing now, however, as more and more breast cancer survivors are engaging tattoo artists for a more lifelike design only a skilled artist can achieve.

“For me it’s a pretty simple tattoo,” says Hendon, who has been doing these tattoos for more than 20 years. They’ve become a passion for him.

Tattoo Ink

Mastectomy tattoos are gaining popularity among breast cancer survivors. Not only do these tattoos look incredibly realistic and almost three-dimensional, they also offer women a sense of comfort in reclaiming something they had to sacrifice to the disease.

Sharp's decision to get the tattoos was an easy one. “For me it was a little over an hour of my time and $400," she said, "and I came out feeling like a complete woman again.”

From Under the Knife to Under the Needle

Some women chose to have a more artistic design to cover their scars. Hendon says he has seen this trend start primarily in California, and he has been asked to do more and more designs in the past few years. The most requested designs coming out of his shop are any type of flower. Hearts and pink ribbons to symbolize breast cancer awareness are other popular choices to mask scars.

While a majority of the clients Hendon has coming in for this type of tattoo are breast cancer survivors, it is not an exclusive procedure to those who have battled the disease. Roxie Greene has never had breast cancer, but she did have a breast reduction that left her with several scars across her chest.

“I would look in the mirror and just cry, it was horrible to look at,” Greene explains, “I wanted to cover them with something pretty, like art.”

Hendon tattooed vines of purple and pink flowers across Greene’s chest to cover her scars from surgery. Greene sees her tattoos as a work of art that has boosted her self-confidence.

“My tattoos have changed my life so much,” she says,“and for any woman who has had breast cancer, it must really be something for her. There is so much that can be done, and you can choose whatever you want to make it beautiful.”

‘The Easiest Tattoo You’ll Ever Get’

Sharp and Greene say their tattoos have helped them reclaim their femininity and feel beautiful. And for women who have fought breast cancer and come out on top, going under the needle tattoos is nothing compaed to what they’ve been through.

Sharp wants other women who fear tattoo needles and the pain that comes with getting inked to know that the process is actually quite painless. During a mastectomy, nerves are severed when tissue is removed. As a result, Sharp lost all feeling where her breasts were operated on. 

“It's the easiest tattoo you’ll ever get,” she said.

For those considering a mastectomy tattoo, Hendon stresses this is not the kind of tattoo you can just walk into any downtown parlor and request. He says it's important to find a reputable artist who knows how to properly work with the skin of reconstructed breasts.

For those considering a mastectomy tattoo, Hendon stresses this is not the kind of tattoo you can just walk into any downtown parlor and request. He says it's important to find a reputable artist who knows how to properly work with the skin of reconstructed breasts.

P.Ink is a nonprofit organization that aims to connect breast cancer survivors with tattoo artists. On both the website and mobile application, users who are interested in getting a tattoo fill out a short application. The organization then connects each woman with a tattoo artist who specializes in mastectomy tattoos.

There are more than 3 million breast cancer survivors in the United States alone, but even after the cancer is gone, its effects last far beyond the removal of the invasive cells. Mastectomy tattoos offer women a chance to disguise their scars under something beautiful or simply regain part of what has been lost in the fight. 

“The people I get to tattoo aren’t just leaving with a tattoo,” Hendon says. “They can finally feel okay again and be comfortable with their bodies. It’s a new normal, or better than normal, that I’m glad to be a part of.”

Macey Lauren Kessler is a student at the University of Georgia’s Grady College of Journalism.