‘You’re just as good as you were before:’ Areola tattooing helps with healing process after breast cancer

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Warning: This story and accompanying video contains sensitive imagery, including nudity related to breast reconstruction.

It’s been 14 years since Starla Schneider first found out she had breast cancer. Now, after numerous surgeries, reconstructions and treatments, Schneider says she feels “just as good as she was before.”

Schneider came to terms with the fact that she lost her nipples during the reconstruction process.

“Each time I came out of an appointment, I was always reminded … I survived all of it. I’m here, I’m still healthy, and not having a nipple doesn’t define me as a person,” Schneider said.

But she still wanted to look into restorative areola tattooing.

She eventually reached out to tattoo artist Cindy Kenway, who owns Obsidian Tattoos in Qu’Appelle, Sask.

Kenway has been tattooing professionally for more than 29 years. She says she was the first Saskatchewan-based tattoo artist certified for areola restorative tattooing (A.R.T.) back in 2018. 

The training was created by a tattoo artist who went through breast cancer herself. The certification follows a healing-centric approach, which includes acknowledging the triggers and traumatic memories tattoo clients may experience during the tattoo process.

Kenway says restorative areola tattooing is different from cosmetic tattooing. The skin is often damaged from surgery or scarring. She is extra gentle to make sure she is not ripping the skin or damaging it further.

Schneider says she learned about areola tattooing after speaking with her plastic surgeon. Because her reconstruction surgery used skin from her mid-section, she ended up with new, natural looking breasts, but without nipples.

She wondered if new nipples could be constructed using her existing skin and tissues, but had heard they may not last.

“I went to my plastic surgeon and I said, “if you build the nipples, how long are they going to be good for, because aren’t they going to squash down?” and he said max five years, but he did mention about 3D tattooing,” she said.

Schneider contacted Kenway in 2021, and the process began with a consultation and a set of “nipplebacks,” realistic looking stick-on areolas that Schneider could test out for a week.

Once Schneider was happy with them, Kenway drew a stencil and began creating the new designs, with the first appointment focused on colour saturation and the second focused on detailing.

Although Schneider’s plastic surgeon told her about areola tattooing, the procedure is not widely promoted because photos and posts on social media often get reported as inappropriate.

“A lot of it gets flagged and gets taken down, thinking it’s nudity and pornography,” said Kenway. 

It’s also a financial barrier for some people who’ve gone through reconstructive surgery. Kenway charges $200 for one restorative areola tattoo, or $400 for a pair, with free touch-ups for life. The Saskatchewan government confirmed that cost is not covered by the province.

Schneider says connecting with Kenway and getting her restorative tattoos was one of the best decisions she’s ever made. But she wishes other people recovering from breast cancer could do the same, without worrying about money.

“This last step of the areola is something that should be definitely included into this whole process because it’s a piece that is missed,” said Schneider. “It’s taken away from a woman, and I don’t feel that the cost of this here should be neglected.”

For Schneider, this last step brought a sense of normalcy she hadn’t had since before her breast surgery.

“I guess not having certain things, women feel lesser,” Schneider said. “Looking in the mirror and seeing it [the areola] helps you know that you’re good.”