“Patients’ experiences [of paramedical tattooing] in the Western world [often] show that they were not happy with the service provided by hospitals,” Dougall explains. “The process is extremely painful, it fades away quickly and leaves scars that make them feel more embarrassed. Providing another option for people who had anxious and stressful experiences in hospitals is also crucial for their recovery process.”

While tattoo artists aren’t medical practitioners, Dougall says that their experience of tattooing over scars and on sensitive skin can be beneficial and should be recognised: “I know that my skills [and 15 years of experience] could help people start a new chapter of their life”. 

Ko adds: “In my opinion, tattoo artists with extensive traditional tattoo experience have the best potential to become the best paramedical tattoo artists. The extensive skillset, knowledge and artistry from traditional tattooing careers set us apart from medical personnel and cosmetic tattoo beauticians whose speciality does not lie within this scope of work.”

It’s not just preconceptions against tattoo artists and parlours that prevent some mastectomy survivors from undergoing areola tattooing: Singaporean tattoo artist Sumithra Debi says that the nature of the procedure itself can be frightening. 

“These tattoos are highly personal and intimate,” Debi says. “While patients are not sure of what to expect from the procedure, they’re sure that the tattoo will be made on a part of their body that has suffered a lot already.”

“[For some patients] surviving breast cancer makes the aesthetics of their body trivial. So sometimes, some didn’t realise for years how powerful it could be to reappropriate their bodies that way. Nipple reconstruction can be an inherent part of their emotional healing.”

Ko adds that, after going through “so much”, some patients are embarrassed to prioritise taking care of their appearance. “However, I have witnessed more than once that having this final touch is a tremendous help [in terms of] regaining confidence and self-identity, and most importantly, puts a beautiful, symbolic end to a tough journey when done right.”

“You cannot underestimate the psychological effect of regaining a part of your body,” Dougall agrees. “It marks the end of a long and difficult journey that they have been through.”

The last challenge to accessing paramedical tattoos is availability. The certification and seminars teaching artists about techniques for tattooing the likes of hyper-realistic areola and skin pigmentation aren’t widely available in Asia.

“The certification is quite difficult to obtain in Asia,” Debi confirms. “I had to obtain mine from a US-based company. And it took years for doctors to recommend me—so even when I was certified, it took me a lot of time to create a clientele. Also, because of tattoo culture [in Singapore], it’s complicated to [promote this] kind of profile, as it requires us to be completely selfless in our art. We are not using a client as a canvas—we are at their service.”

Ko adds that even once the certification is earned, spreading the word remains a hurdle.

“The biggest challenge in Hong Kong is that most people are not comfortable with us showing their results in our portfolio, which is totally understandable; but without many visual examples, those in need can feel quite lost,” she says. “I am now doing a campaign to provide free areola tattoos for clients who match the criteria I set up, including consent to use the pictures in my portfolio—without [revealing] their identities, of course. I think this is a good way to pay it forward.”

Front & Female Changemakers celebrates the extraordinary journeys of inspiring women who have emerged as powerful changemakers in a range of fields, offering a glimpse into their lives and showcasing their courage, vision and relentless pursuit of change and progress. From social entrepreneurs and business leaders to educators, artists, activists and scientists, Front & Female changemakers exemplify the ability to challenge the status quo and demonstrate the power of women to effect change.

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