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The healing art of 3-D nipple tattoos

Tattoo artist Sasha Merritt trains a nurse on how to administer a 3D nipple tattoo


Two sisters, Kathryn Sibley and Madelyn Blair, walk into the Dragonfly Ink Studio to get a touch-up on their matching tattoos. You can sense their excitement—they’re not scared of the needle and they’re not scared of the pain.

Kathryn Sibley is a two time breast cancer survivor, who had a double mastectomy. Her sister Madelyn Blair also had her breasts removed. Both are here to touch up their 3D nipple tattoos, done originally by the tattoo artist Sasha Merritt.

Merritt has tattooed hundreds of nipples onto reconstructed breasts. A 3D nipple tattoo is essentially a highly realistic portrait of a nipple, one that gives the illusion of protrusion. They are a nonsurgical alternative to nipple reconstruction, for women who don’t want to spend more time in an operating room. This kind of figure drawing comes natural to Merritt—aside from being a body artist, she’s also a painter.

“It's exactly the same thing,” says Merritt. “You know you still have to do shadow, you still have to do where is light is reflecting, you have to do all those kinds of things.”

Shadow, light, color—these are the tools in Merritt’s arsenal. She lines up her bottles of ink, all fleshy pinks and browns, and gets to work.

The process doesn’t take long—just a couple of hours—but for her clients, it’s really emotionally complicated. Kathryn Sibley explains, “there's the story of stepping out of the shower every day and seeing your reflection and realizing you went through this cancer, you know, you went through this ordeal.”

For Sibley, her nipple tattoo symbolizes the end of a long journey with breast cancer. When the cancer came back the second time it was more aggressive—after chemo and radiation, she knew she would eventually have to get her breasts removed.  “For six months or so, I would wake every morning and think that while I was brushing my teeth they are not going to be with me,” she says.  “So I had that time to grieve in advance.”

For her sister, Madelyn it was different. She tested positive for the BRACA gene, and after a mammogram turned up with some abnormalities, she made the decision to get a bilateral mastectomy as a preventive measure.

“It was the biggest decision of my life, really,” says Madelyn Blair.  

Now, a couple years and many procedures later, the sisters find themselves here. They aren’t shy about undressing—their breasts have been examined, radiated, removed and reconstructed—so being tattooed doesn’t faze them.


Merritt moves her tattoo machine in tight small circles, reinforcing the color with added shading and blending. When she’s done  Madelyn Blair looks over her shoulder in the mirror, trying to examine her breasts from all angles. Her sister marvels.  “I used to see your scars so much more,” Sibley tells her. “And now I really don't see them.”

Sibley is a true nipple tattoo believer—partly because it’s been such a battle with her doctors and insurance company to make it happen. “The one doctor said it can’t be that difficult—it’s just two red circles or whatever,” Sibley recounts. “I didn't want to get the Target logo on my chest.”

Nurses and doctors aren’t generally trained in the artistry of tattooing, and it wasn’t until 1998 that insurance companies were required to cover reconstructive breast surgery. But nipple tattoos aren’t part of the coverage if they’re done by tattoo artists like Sasha Merritt—something that doesn’t sit well with Sibley. “They took your nipples off they should put them back on,” she says. “That’s reconstruction!"


Because she knows the tattooing will get covered by insurance if it’s done by a medical professional, Merritt’s been going  out of her way to train other nurses in the Bay Area in the art of nipple tattoos.  

“I think it's a learnable skill,” Merritt says. “And I think that insurance companies lose out by not bringing tattoo artists into the fold.”

And she’s getting hospitals involved. She recently worked  with the San Francisco General Hospital, under a grant program where she provided her nipple tattoos for free to 43 women. UCSF then surveyed the tattooed women to evaluate the emotional benefits of this kind of procedure. They hope to use their findings to make these artful tattoos a more permanent part of the reconstructive process.

When it’s Kathryn Sibley’s turn, she scoots into position, staring at the ceiling, and cracks jokes from start to finish. When the session’s over, Sibley inspects herself in the mirror. Her new nipples remind her of a body restored—the one she had before illness. “For some reason, the nipples help you focus on the breasts, and the scars kind of fade away, and you find yourself not really thinking about it,” she reflects. “And that's the best place to be, and that's when you are really healed when you’re not—when it’s not in your mind anymore, that you’ve been through this.”

Her tattoos are shockingly realistic, they're blurred at the edges, proportional, a shadow near the curve of the areola, like  a painting come to life; the scars, you don’t really notice them.

Hannah Kingsley-Ma is a reporter and producer living in San Francisco.