Karen Malkin-Lazarovitz

Mastectomy tattoos: An alternative to reconstruction after breast cancer


Over more than four decades of existence, Hope & Cope has supported and empowered thousands of women with breast cancer. Today, we are proud to celebrate one of our former employees, Karen Malkin-Lazarovitz, as she makes her mark on the world and on women’s lives.

Women often face few options after a mastectomy. One option is to leave the scar as is. But every look in the mirror is a reminder of her cancer diagnosis, the treatments, and the surgery.

Some women choose to go flat and request a flat closure.

Another option is to undergo breast reconstruction. It can be painful and lead to complications that require more surgeries. And some women choose breast reconstruction not because it’s what they want but because they feel pressure — real or perceived — from their loved ones, doctors, or society.

Fortunately, this situation is changing, and women now have more options. One of those options is to get tattoos, says Karen.

Beauty on the woman’s terms

“After breast cancer surgery, patients should have other options besides reconstruction or remaining flat,” Karen explains. “I want to give women the chance to define beauty on their terms.”

When she was 33, Karen discovered she had the Breast Cancer Gene (BRCA2) mutation. It gave her an 87% chance of developing breast cancer and a 40% chance of ovarian cancer.

To avoid that fate, she chose to have a hysterectomy, an oophorectomy (removal of the ovaries), and a double mastectomy. She also had breast reconstruction, which led to complications and eight more surgeries.

After the fifth surgery, doctors encouraged her to get nipple reconstruction. But she had had enough. Instead, she looked for another solution and found an artist willing to do a tattoo to cover her scars.

She shared the results on Facebook. There was so much interest from other women that she started looking at how her experience could make a difference in women’s lives.

Her solution: to partner with tattoo artists and offer free tattoos for women with a breast cancer mastectomy. She teamed up with Personal Ink, an American organization, in 2017. While working with Personal Ink, she provided 23 tattoos.

In May 2022, she created her own non-profit organization, EMPOWERink, and has already provided 42 tattoos.

How are the tattoo artists chosen?

The tattoo process for someone who’s had a mastectomy is delicate.

“You’re dealing with a woman who has mastectomy scars and is already emotionally traumatized in the breast area,” says Karen. “So, the artist needs to be sensitive to the recipient. For many people, it’s a very intimate experience. It’s the first time since their diagnosis that they take back control of their bodies.”

Karen vets every tattoo artist, and she’s had artists reach out to her for the wrong reasons.

“I’m not interested in working with someone who just wants more views and likes on their Instagram profiles.”

The artists Karen chooses understand that it’s not about them. It’s about what the recipient wants.

Photo credit: Lee Nisar, used with permission

They need to be comfortable tattooing scar tissue and radiated skin that has lost some of its elasticity. They also must understand the limitations of tattooing someone with lymphoedema.

The response from the ink artists’ community has been phenomenal. A few times per year, Karen holds EMPOWERink Days in various cities in Canada, including Montreal, Québec, Toronto, and Oshawa. She hopes to add Edmonton next year.

On EMPOWERink Days, an artist meets a breast cancer survivor to create the decorative tattoo she has chosen. Tattoos are provided free of charge.

“Four years ago, we were able to provide tattoos for 3 or 4 ladies per year,” says Karen. “I was working with an award-winning tattoo artist who spoke about it to his artist friends. They all wanted to contribute. Now we do 25 tattoos per year.”

Is getting a tattoo the right solution for you?

Getting a tattoo is a personal choice. Other options may be more suitable, and if you are unsure, Karen says you should talk to your doctor. (In particular, tattoos are not recommended for women with inflammatory breast cancer.)

“I’m not a healthcare professional,” she says. “So when someone considering a mastectomy tattoo asks me if it would be dangerous for them, I recommend they speak to their doctor. That said, we’ve done almost 65 tattoos so far and never had a problem.”

If you’re considering getting a tattoo, you must be at least one year post-breast cancer surgery to be eligible. You must also include a picture of your chest with your application so Karen and her team can determine if there is a good fit. That’s not always the case.

Photo used with permission.

It’s great if you know what type of tattoo you want, but it’s not essential.

“You might not know what you want, but my Instagram probably has every kind of mastectomy tattoo design you can think of,” Karen says. “Women find tattoo ideas there and send me five images they like. That allows me to match them with the perfect artist.”

A mastectomy tattoo can be a life-changing option

Looking through Karen’s Instagram, it’s hard not to be moved by the smiles, the laughter, and the tears of joy when women see their newly tattooed chests for the first time.

“It’s been a year and I still smile in the mirror when there used to be tears! I look at my breast with awe now. It never felt a part of me until that day!”

Luanne B

And that is helping to change attitudes around options for women after a mastectomy. Even men who are treated for breast cancer are also opting for tattoos.

“My most recent surgery was right before the pandemic, and my biggest concern was whether it would ruin the tattoo,” explains Karen. “My surgeon said, ‘I won’t touch the tattoo. It’s too beautiful.’ So, there are surgeons who understand better the effects reconstructive surgery can have. But they don’t know what they don’t know. Sometimes it’s up to the patients to discuss other options and enlighten them.”

You can find Karen’s Instagram account at: https://www.instagram.com/empowerink_ca/

If you have the BRCA gene mutation, you can join the BRCA Sisterhood Facebook group to exchange with other women in the same situation. The group is private, so reach out to Karen if you would like to join.

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