The Restorative Power of Medical Tattoos | Becky Barker | TED

Let's talk about tattoos, shall we?

(Laughter)

I know some of you here tonight

have probably got a sneaky little tattoo hidden away,

which means you're in the cool club.

Don't worry, the cool club's not exclusive,

you can join at any time.

(Laughs)

But what really springs into mind when I say the word tattoo?

Is it artistic, expressive, beautiful, ugly, intimidating,

just not for you?

There's no wrong answers, by the way.

Have you ever considered tattoos to be empowering or healing?

Tattoos are actually steeped in the history of healing.

5,000-year-old Ötzi the Iceman

was discovered with markings tattooed on his limbs

in areas that would have been causing him chronic pain.

In cultures and tribes throughout history, and even in modern times,

symbols are tattooed onto parts of the body

to alleviate symptoms of chronic illness.

And it works.

Now whether you believe in "juju,"

mind over matter healing or placebo effect,

or whether you consider this may actually be a science not yet proven,

there's something pretty special about using tattooing for healing.

In our culture, we focus more on aesthetics, don’t we?

But tattoos can still be very healing.

If someone has a part of their body that they don't like to show off,

you put a tattoo that they really love on there,

they are first on the nudist beach in the summer every time.

(Laughter)

People use decorative tattoos to cover scars

or to signify a fresh start

or even to commemorate a loved one that they may have lost.

And all of those things can have such a positive effect

on someone's mental health.

But tattoos are not just for adornment.

They also have a place in the medical field.

Tattooing without pigment, known as microneedling,

dry needling, collagen induction therapy,

can have an amazing effect on scar tissue.

It can reduce tightness in a scar, aiding mobility.

It can flatten a raised scar.

And it can reduce the appearance of a scar.

We can even add skin-tone pigment into a scar

to reduce the contrast between the scar and the surrounding skin,

giving a camouflaged effect.

We can tattoo hair follicles to give a balding gent a shaved head look

or to add density to thinning hair,

which is amazing for all genders.

We can tattoo eyebrows, belly buttons, toenails.

We can improve the appearance of a cleft lip.

We can separate webbed toes.

The possibilities are endless.

Tonight, we're going to talk about areola restorative tattooing.

This is where we fix or create an areola, a nipple complex,

generally for people that have been through some kind of surgery.

There are many reasons as to why someone would go through breast surgery.

But tonight, we're going to focus on breast cancer.

When somebody loses their breast to cancer,

they have a mastectomy, and they choose to have a breast reconstruction.

The majority of time, the nipples don't make it.

And when this happens,

that person often doesn't connect with their new breast.

They don't have an emotional attachment to it,

they just see it as lumps of skin.

And sometimes when you add a nipple and areola complex

to a reconstructed breast,

it's like putting the cherry on the cake.

(Laughter)

It allows that person to feel a sense of wholeness,

confidence,

maybe even a little bit sexy.

And it's an interesting phenomenon.

When you put a nipple onto a breast that didn't have a nipple,

all of a sudden it's a bit taboo.

But what happens if that tattoo fades?

Does the empowerment fade as well?

I'm going to talk through how I came to the answer to that question.

I started my tattoo apprenticeship in 2008.

I use the term "apprenticeship" very loosely

because there actually aren’t any formal qualifications in any kind of tattooing,

and there aren't any regulations regarding quality.

So an apprenticeship in traditional body art is work-based training.

You work under master tattooers,

learning everything that you need to know about how to tattoo

before you even ever do a tattoo.

The day I came to create my first tattoo was the most terrifying day of my life.

(Laughs)

And the only thing I could liken it to is like learning to drive.

I'm guessing most of you have sat in a car at some point,

and a lot of us have sat in cars our whole lives.

We've watched other people drive.

They make it look really easy.

Some people can even multitask while driving.

Not recommended, but they can do it.

And then when you get into that driver's seat yourself for the first time,

you suddenly realize you're in charge of a death machine.

You don’t know which foot the brake pedal is

or what gear you’re supposed to be in.

You’re driving in the middle of the road,

you're about to hit your mates,

everything feels like you're moving really fast,

you must be doing 90 miles an hour.

You’re going five miles an hour, and there’s a queue of traffic behind you.

That for me is what learning to tattoo was like.

There are so many variables.

You’ve got to think about your setup, your machine, the person’s skin,

the person's pain threshold.

The list goes on, and it’s very overwhelming.

It takes most tattoo artists about three years of full-time tattooing

to reach a point where tattooing actually becomes like second nature,

the same as driving becomes second nature after a while.

I was doing work-based training, so I always had support.

If I came across a situation I didn't know how to overcome,

I had someone to help me,

which meant that nobody ever left me with a really terrible tattoo.

(Laughter)

Which is important

because as empowering as a great tattoo can be,

a bad tattoo can have a really negative effect

on someone's quality of life.

If learning how to tattoo body art is like learning to drive a car,

learning how to do medical tattooing on damaged skin that's scarred

or may have been through radiation or had necrosis

would be like learning to drive an Arctic lorry.

Same basic skill set,

but a lot more pressure and a lot more knowledge needed.

When I decided I wanted to move into medical tattooing,

I went about my learning in two ways.

The first, like most people that want to learn anything, I did a course.

And the course I chose to do was in areola micropigmentation.

This word micropigmentation is a little bit misleading.

It sounds very clean, doesn't it?

It sounds professional, very suit and tie.

But I'm going to tell you a secret.

It means tattoo.

(Laughter)

Micropigmentation is the act of implanting pigment into the dermis,

which is the definition of a tattoo, but it sounds nicer, doesn't it,

a bit less scary.

The difference appears to come

in the fact that micropigmentation is designed to fade,

and it's really designed for the tattooing of eyebrows,

lips and eyeliner,

and it's designed to fade and facilitate a regular top up.

And when it comes to permanent makeup,

there are many reasons as to why that would be important,

but one of which is that fashions change.

I'm not sure about you,

but my nipples have never really been affected by fashion.

(Laughter)

These courses last about two to three days,

and they're aimed at people that already do micropigmentation,

so permanent make-up artists.

But they are also aimed at people

that have never even seen a tattoo machine before,

such as people from the medical field,

which would be like teaching someone to drive an Arctic lorry in two days

and just handing them the keys without them having ever driven a car,

wouldn't it?

Even after ten years of tattooing body art,

my two days didn't fill me with confidence.

I needed more knowledge.

I chose to do a mentorship with a lady called Stacie-Rae Weir.

Stacie-Rae is the founder of ART

which stands for Areola Restorative Tattoo,

and it's a global collective of highly skilled restorative tattoo artists

that all work to a standard set by ART.

In an industry that has no standards,

a standard that's high enough is really important.

ART focuses on three main aspects.

The first is experience.

We can't learn how to tattoo damaged skin

until we've mastered tattooing healthy skin.

We have to learn how to do something called reading the skin.

This is where we can tell, as we're tattooing,

how much trauma we are causing,

when to change our techniques.

That takes time, that needs experience.

The second is realism.

Nipples are as unique as fingerprints,

although not an alternative to fingerprints.

(Laughter)

We have to have some artistic ability to create something truly realistic

that's actually going to make someone feel whole again.

And the third is permanence.

I have to be completely honest.

I didn't really grasp how important permanence was

when it came to these tattoos,

until I started doing them out in the big, wide world.

People still come to me with these really strange pink smudges

where their nipple should be.

And this is what's left over from micropigmentation.

This is the fading tattoo.

I had one client who had areola micropigmentation

performed 12 years before she came to me.

And she was so disappointed with the way her breast looked

with these strange pink smudges

that she hadn't shown anyone her breasts in all that time,

not even her husband.

And now she feels so confident

after I tattooed a realistic nipple and areola complex for her

that will last forever,

she has allowed me to show you the picture tonight.

So that's how empowering a tattoo can be.

But it did get me thinking,

why aren't we talking about this?

How many people are suffering in silence?

It's not the kind of thing you talk about down the pub, is it?

"Alright then? How's your nipple doing?"

We just don't talk about it.

I wanted to give people a voice.

So I put together a survey.

With the help of ART and the Nipple Innovation Project,

we shared this survey globally,

and we asked people that had had restorative tattooing done

of their areola,

how they felt once it had healed.

We already know from previous studies and experience

how amazing getting a nipple tattoo can be

for someone that hasn't got a nipple.

But we wanted to establish whether there was a link

between the healing of that tattoo and how that person felt moving forward.

Unsurprisingly, the majority of people that completed our survey

had had areola micropigmentation done,

meaning that their tattoo faded.

Of this group, 81 percent admitted that they were not satisfied

with the healed results.

51 percent admitted that they had suffered adverse mental health effects

due to the healing of their tattoos.

There were a lot of really heartbreaking comments on this survey,

and the one that spoke to me the most

is that there is a lady

who keeps her bra on in the bath

because she hates the look of her breast reconstruction so much

because of her faded nipple tattoos.

Imagine keeping your clothes on in the bath

just in case you catch a glimpse of yourself in the mirror.

Imagine being the surgeon that has spent hours creating a really beautiful,

symmetrical breast reconstruction

to have it aesthetically ruined by poor nipple tattoos.

I am a trustee for the Nipple Innovation Project.

We are the UK's first tattoo cancer charity,

and our mission is to empower and dignify breast cancer survivors

with 3D, realistic, permanent nipple tattoos.

We have a directory of artists throughout the UK

that all work to a standard set by NIP,

another standard, very important,

and funding is available from the charity

so that there is no financial burden on the clients.

Our campaign for this year has been #mychoice.

True empowerment comes from making an informed decision.

We believe everybody should have access to all of the knowledge that they need

to make this decision.

Some people were never told that their tattoo was going to fade.

Some people found the idea of going back to hospital every year for a top up

too traumatic.

People should know that there is a safe, permanent alternative.

We recently spoke at the oncology convention at the NEC,

which was a great success,

and one of the points that we were really trying to make

is that just because someone’s got funny-colored hair and tattoos

that draws on people with electric crayons for a living,

it doesn't mean that we're not professional.

It doesn't mean that we're not producing quality results.

And it certainly doesn't mean we don't care about our clients.

Long gone are the days of the backstreet tattoo studio,

tattooing is actually a pretty upstanding career now.

(Laughter)

So there you go.

The word tattoo is not a dirty word.

It's a transformational word.

It's a life-changing word.

And when you give someone a tattoo that truly makes them feel whole again,

it gives them confidence and a better quality of life,

that, my friends,

is how you use tattoos as a tool for empowerment.

Thank you.

(Applause)