Breast Cancer

Are Breast Tattoos Safe?

+ CV Skinlabs Team

Nipple Tattoos Help Breast Cancer Survivors Feel Like Women Again.” This was the headline of a July 2011 news article featuring The Beau Institute, which offers free nipple tattooing for breast cancer survivors.

Is this a good idea? Is it safe?

In May 2010, I published a post on the dangers of lead-based inks in tattoos. (See my featured interview with Telemundo on the subject in the video above.) The American Environmental Safety Institute (AESI) had found through research that the amount of ink needed for a medium-sized tattoo could contain between 1-23 micrograms of lead, more than the 0.5 microgram-per-day recommended limit.

I also noted that the American Academy of Dermatology (AAD) stated that tattoo inks can contain aluminum, copper, iron, sulfur, barium, nickel, cobalt, chromium, and more. All of these heavy metals have been scientifically determined by the state of California to cause cancer. The Mayo Clinic also warns that tattoos can increase your risk of blood-borne diseases like HIV, hepatitis B, and tetanus.

So are the technicians who are granting breast cancer survivors taking these risks into account when they’re putting tattoos on breasts that have already been affected by cancer?

What are Breast Tattoos?

Many women today who go through a mastectomy can request nipple-sparing surgery, which gives a more natural appearance after reconstruction. Sometimes, however, it’s not recommended, as it leaves some breast tissue behind that may be susceptible to cancer. Women who have large tumors or complicated cancers may not be candidates for nipple-sparing options.

For women who are unable to save their nipples-or who are just tired of surgery and don’t want to face reconstruction-there is another option for real-looking breasts: nipple tattoos. Some tattoo artists are gaining reputations for creating real-looking nipples that fool even doctors. According to recent news articles, these tattoos can help women regain their confidence and feel better about the appearance of their breasts.

Lillie Shockney, for instance, a nurse at Baltimore’s Johns Hopkins Breast Center, went to see tattoo artist Vinnie Myers after she saw his work on one of her patients. When he finished with her tattoo, “he turned my chair so I could see what I looked like in the mirror, and I burst into tears because they truly look real,” she told the NY Daily News.

Are They Safe?

As to whether nipple tattoos are safe-particularly on breast cancer survivors-we just don’t know. So far, there is hardly any information on the safety of this particular procedure. Many medical specialists aren’t even aware of the option yet, but it is on the rise.

Dr. David Passeretti, a plastic surgeon who has performed breast reconstructions for eight years, says that tattoos are safe after breast reconstruction. Yet in 2012, the Centers for Disease Control and Prevention (CDC) called for higher standards on tattoos, as currently, the FDA treats them like cosmetics and does not review inks for safety.

“Because tattoo inks are injected intradermally,” the CDC stated, “CDC recommends that ink manufacturers be held to higher product safety standards, which should include production of sterile inks.”

Sterility is a concern, as in 2012, the FDA launched an investigation of inks connected to illnesses caused by the nontuberculous Mycobacteria (NTM). They traced the sicknesses back to a type of ink used to tattoo people in Washington, Iowa, and Colorado, and eventually recalled the implicated link. But this was long after several people had already suffered.

People can also experience reactions after being tattooed, including infection, allergic reactions, scarring, granulomas (knots or bumps around the tattoo area), and MRI complications (swelling or burning in the tattoo during an MRI test).

The FDA warns that some pigment from tattoos can migrate from the tattoo site to the body’s lymph nodes. Whether this may cause health complications we don’t know yet-the National Center for Toxicological Research (NCTR) is doing further research.

Meanwhile, should survivors be taking the risk?

Potential Carcinogenic Activity of Inks “Unclear”

In an article published in the journal The Lancet Oncology in 2012, researchers wrote, “the potential local and systemic carcinogenic effects of tattoos and tattoo inks remain unclear.” The scientists reviewed studies on tattoos and cancer, and found 50 cases of skin cancer on tattoos-a small number, relatively.

So far, however, we have no studies directly connecting tattoos and cancer. The FDA is investigating how the body breaks down the tattoo ink as it fades over time. The agency says there are more than 50 different pigments in use for tattoos. Some are approved for topical use in cosmetics, but none are approved for injection into the skin.

Of concern as well are the new ingredients now being used to make some inks. In an effort to get away from the metals, manufacturers are now turning to plastic-based pigments also used in textiles, printing, and automobile paint, especially for intense reds and yellows. These may include phthalates and hydrocarbons that are potential carcinogens and endocrine disruptors. Black inks can contain polycyclic aromatic hydrocarbons (PAHs), including benzoapyrene, a compound identified by the EPA as among the most potent and well-documented skin carcinogens.

“The short answer is we don’t know if the chemicals in tattoo inks represent a health hazard,” said Joseph Braun, an environmental epidemiologist at Harvard University.

Experts caution not to get tattoos over existing moles, as they can cause a bump or lesion resembling a type of skin cancer, that may eventually require treatment. Is it safe, however, to put a tattoo over a surgery site, such as after breast cancer treatment?

Bottom Line

Breast cancer can be a devastating experience, and there’s no doubt that learning how to adapt to the major body changes can be super challenging. Women who make efforts to take steps that make them feel more confident and attractive are to be heralded for their positive attitude and courage.

If you’re thinking about getting a nipple tattoo, however, please see my former post for help in making sure that your tattoo artist shop is as reputable and sterile as possible. Then think long and hard about your decision. Remember that the natural aging process may cause the tattoo to become distorted, and that it is likely to be difficult to change or alter. Make sure you’re okay with the risks, and realize that you’re body has been through a lot, and is likely still recovering. You need a strong immune system to fight off cancer-and tattoo inks may further challenge your system.

What do you think about nipple tattoos? Have you gotten one? Please share your experience.

Picture courtesy marin via


Rheana Murray, “Tattoo artist creates 3D nipples for breast cancer survivors,” NY Daily News, February 21, 2013,

Karen Kaplan, “FDA and CDC warn that tattoo ink can be hazardous to your health,” Los Angeles Times, August 23, 2012,

Nicolus Kluger, Virve Koljonen, “Tattoos, inks, and cancer,” The Lancet Oncology, 13(4):e161-e168, April 2012,

Joyce Davis, “Reactions to tattoo ink prompt warnings, study,” Herald, March 16, 2013,

Damien Gayle, “Now tattoos give you cancer: U.S. regulator probes fears inks contain carcinogenic chemicals,” Mail Online, September 1, 2011,

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