Data Research
AMT advocates for clinical health psychologists to conduct research to help us understand how medical tattooing may help with mental health and cosmetic outcomes following breast cancer surgery and treatment. You can view some of our board member’s published work regarding the applications of medical tattooing below:
Adam Daly, Johannes Karl, Simon Dunne (2024)“Art is just something that makes people heal”—a qualitative investigation of tattoo artists’ perspectives on cancer survivorship therapeutic tattoos. Springer Science+Business Media, LLC, part of Springer Nature 2024. https://doi.org/10.1007/s11764-024-01682-4
Abstract
Purpose
Many cancer treatments can lead to a disrupted body image and identity. One intervention to address these outcomes is therapeutic tattooing. However, despite the wide dissemination of this practice for cancer survivors (CSs), current research on it is lacking. This study aimed to identify tattoo artists’ (TAs’) perspectives on the types, impacts, barriers, and facilitators of therapeutic tattooing for CSs and the impact of doing this work on themselves.
Methods
Twenty-two international TAs who tattoo CSs were interviewed and resultant transcripts were analyzed thematically.
Results
The following themes emerged: Emotional Management of Artists, Emotional Transformation of CSs, Stigma and its effects on CSs, Artist Barriers, CS Barriers, Artist Facilitators, and CS Facilitators. The findings also identify a typology of cancer survivorship therapeutic tattoos.
Conclusion
This is the first study to identify barriers/facilitators of therapeutic tattooing, a typology of cancer survivorship therapeutic tattoos, TAs’ perspectives on therapeutic tattooing, and potential negative outcomes from this practice. The findings indicate that therapeutic tattooing can be both beneficial and harmful for CSs and TAs, that there is a need for better therapeutic tattooing training for TAs and healthcare providers (HPs), increased awareness of therapeutic tattoos, and a reduction in barriers to the practice and greater collaboration between HPs and TAs.
Implications for cancer survivors
Findings from this study have major policy implications for healthcare systems, non-profit organizations, and regulatory bodies, which could serve to empower cancer survivors to make more informed decisions about their bodies and support enhanced training and accreditation of this practice.
Breast Cancer Survivors’ Perceptions of Mastectomy Reconstruction: A Comparative Analysis of Medical Tattooing Impact on Aesthetics
Proctor, M., Cassisi, J.E., Dvorak, R.D. (2024). Breast Cancer Survivors’ Perceptions of Mastectomy Reconstruction: A Comparative Analysis of Medical Tattooing Impact on Aesthetics. Aesth Plast Surg. https://doi.org/10.1007/s00266-024-04484-2
Submit an inquiry on our contact page for access to the full PDF
Abstract:
Background
Studies indicate that physical appearance changes affect a significant proportion of breast cancer survivors, often leading to post-surgical distress. Both reconstructive surgery and medical tattoos are associated with patient-reported satisfaction, yet further research is necessary to understand their combined impact on aesthetic outcomes from the patient perspective. This study examined how breast cancer survivors evaluated the cosmetic and decision satisfaction of other patients who made various cosmetic intervention choices post-mastectomy.
Methods
Breast cancer survivor support networks (n = 180) across 20 states agreed to share information about the online survey to their members. Participants (n = 251) rated the cosmetic outcome and decision satisfaction of images depicting other patients who had received mastectomy with three types of intervention: reconstruction alone, medical tattooing alone (flat closure), and reconstruction and medical tattooing combined.
Results
A factorial MANOVA produced significant within-subjects effects indicating participants consistently rated images of patients with a combination of reconstruction and medical tattooing highest in cosmetic quality, lowest in scar visibility, and highest in treatment decision satisfaction.
Conclusions
The findings suggest that medical tattooing serves as a valuable complementary cosmetic intervention, with many survivors expressing interest and recognizing potential benefits once informed about the option. However, the study’s limitations, such as the need for a more diverse range of patient images for evaluation, should be acknowledged. Future research should address these gaps by incorporating photographs of patients across varying demographics, including age, body weight, disease severity, and surgical procedures, to minimize bias. Despite these limitations, this study highlights the significant role that medical tattooing can play in enhancing aesthetic outcomes after surgery, particularly from a patient-centered perspective.
Level of Evidence III
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://link.springer.com/journal/00266.
Proctor, M., Cassisi, J.E., Dvorak, R.D. & Decker. V. (2024) Medical tattooing as a complementary cosmetic intervention to reduce body-image distress and mental health symptoms in U.S. breast cancer survivors. Support Care Cancer 32, 600. https://doi.org/10.1007/s00520-024-08809-4
Submit an inquiry on our contact page for access to the full PDF
Abstract:
Purpose
A review of the literature revealed a high incidence of body-image distress among breast cancer survivors who had surgery. This cross-sectional study examined the relationship between medical tattooing as a complementary cosmetic intervention and body-image distress and mental health outcomes among breast cancer survivors following surgery.
Methods
We examined 330 post-surgical breast cancer survivors collected through a nationwide online survey in the U.S., pursuing two main objectives. First, we investigated body-image distress, depression and anxiety symptoms, and perceived stress in survivors who underwent breast cancer surgery, comparing those with medical tattooing (n = 89) and those without (n = 226). Second, we assessed the influence of the participant’s surgery type on body-image distress, depression and anxiety symptoms, and perceived stress. Additionally, we evaluated whether individual factors, such as appearance investment, satisfaction with decision, and cosmetic expectation discrepancy, predicted the participant’s body-image distress.
Results
Findings suggest that participants with medical tattoos reported significantly lower body-image distress, depression and anxiety symptoms, and perceived stress compared to those without medical tattoos. The participant’s surgery type did not significantly predict body-image distress, depression or anxiety symptoms, or perceived stress. However, participants who reported greater appearance investment endorsed higher body-image distress. Participants who reported higher satisfaction with their treatment decisions and lower cosmetic expectation discrepancy endorsed lower body-image distress.
Conclusion
Medical tattooing may be a valuable tool in improving body-image distress and mental health for those who wish to pursue it, but more research is needed. Empirical studies supporting the mental health benefits of medical tattooing among survivors are crucial to standardize insurance coverage and promote its inclusion as a complementary intervention across insurance providers nationwide. This complementary intervention should be considered using a patient-centered approach that aligns with the patient’s values and preferences.
Becker, S. J., & Cassisi, J. E. (2021). Applications of Medical Tattooing: A Systematic Review of Patient Satisfaction Outcomes and Emerging Trends. Aesthetic surgery journal. Open forum, 3(3), ojab015. https://doi.org/10.1093/asjof/ojab015
Abstract:
Background
Medical tattooing is often applied in the context of plastic, aesthetic, and reconstructive surgery to help achieve the best cosmetic outcome.
Objectives
This article reviews various conditions that medical tattooing has been empirically studied in terms of patient satisfaction outcomes, makes practice recommendations, and suggests future directions for research.
Methods
This review was performed following the PRISMA guidelines. Studies were included if the tattooing application was associated with a medical condition and if outcome data were provided using at least a case series methodology. Where no cohort or clinical series exist, case examples are used from the literature and the author’s practice to illustrate emerging medical tattooing applications that need further evaluation.
Results
Eighteen studies met the inclusion criteria and addressed the following conditions: baldness, vitiligo, scars from incisions, lacerations or burns, and nipple-areola complex reconstruction.
Conclusions
The application of medical tattooing has shown high levels of patient satisfaction across conditions. The practice recommendation grade is “B” or recommend since the level of evidence for these interventions ranged from III to IV according to the American Society of Plastic Surgeons guidelines. This means clinicians can consider this treatment alternative, but they should be alert to new information and be sensitive to patient preferences. Recommendations are made for reporting future research including clearly describing procedural details, identifying the professional performing the procedure, increased use of standardized outcome measures, and that satisfaction ratings be assessed by someone independent of the health service provider. Further research using randomized controlled trial methodology with waitlist controls is needed.
Alliance of Medical Tattooing Survey
Right now, we are accepting participants to complete the below survey regarding their experience with medical tattooing. We hope to use this information for future research and publications to aid us in standardizing the process and providing best practices and results.
Ongoing Survey Link: https://ucf.qualtrics.com/jfe/form/SV_0N7j600BIdueO4S