When a woman came to Damien Deeds’ Manhattan tattoo parlor last year with a five-inch perforated keloid scar across her shoulder blade, he saw a creative opportunity.
The keloid, an overgrowth of swollen, rubbery scar tissue, was “sticking out, looking almost like a slug,” the 27-year-old artist said. “What I did was I created wings around it and encased the scar into the shape of the body of a butterfly. Very simple, and she loved it,” he said.
The procedure, called scar tattooing, is still relatively uncommon, but more tattoo parlors and artists around the country are taking on the challenge, with increasingly imaginative results. The process is not without risks, but those who have received the tattoos say the immeasurable boost to their self-image outweighs any health concerns they may have had.
Sasha Merritt, 38, is one of the few tattooists in the country specialize in the practice. She has run a parlor in San Francisco’s gritty Mission District for the last 10 years, but started tattooing over scars only in the last five, after a friend who had had a mastectomy approached her with the idea.
Since launching her Web site, www.dragonflyink.com, a year ago, Merritt says she’s received requests for scar tattooing from people all over the country, and even one from England. Today, the scar work accounts for a quarter of all her business, with about two new requests per week.
Last year, Deeds began getting requests for elaborate tattoos from women in Hispanic enclaves of Inwood and Washington Heights in upper Manhattan. “I’ve seen them as young as 19, but generally the women who get the work done are anywhere from early 30s into their 50s, usually single,” he said. “They get tummy tucks when they go back to the Dominican Republic, and then they come to me to rectify what the surgeon left.” He estimates he designed and created about 40 original scar tattoos last year.
Unlike Merritt, whose Web site spells out for customers the difficulty and extra time required for tattooing scars, Deeds said that it can be “total war” when it comes to negotiating a price. Because tattooists charge by the hour, the additional work time can raise the price by as much as $50 to $100, he said, bringing the range to $200 to $350. Many of his customers don’t initially understand all the complexities involved in applying ink to scar tissue, he said.
For starters, the new tissue can be less receptive to the ink, said Merritt, requiring several runs in some instances. In addition, straight lines usually become fuzzy. For this reason, Merritt is reluctant to do lettering on or around a scar unless the customer intends for such an effect. On the upside, however, people electing to tattoo over a scar say it is often less painful than ordinary tattoos as the skin immediately surrounding some scars tends to lose sensation.
When Elizabeth’s doctor discussed breast reconstruction options following her mastectomy, he gave her two choices: one involved attaching an artificial nipple, the other was to tattoo on an areola. Unsatisfied, she held out for cherry blossoms.
“At first I was going to leave it alone completely,” said Elizabeth, who asked that only her middle name be used. “But then I decided if I was going to get it tattooed over, I wanted it done by a professional artist and I wanted something different.” She found Merritt through an Internet search.
This type of tattooing does require some precautions. People should wait at least a year before tattooing over a scar, said Dr. Thomas Le, the director of the Facial Plastic Surgery Department at the University of Maryland Medical Center. Otherwise, they risk irritating skin tissue that is essentially still healing, he said. He also cautions that scars often change color in the first year or so and tattooing over one too soon can result in a regrettable mismatch.
Perhaps the biggest risk, though, involves keloid scars, which are easily exacerbated by careless needlework. Merritt said she approaches such scars with extreme caution.
The tattooing industry is not federally regulated and some states require only a business license to open a parlor. The lack of certification and training by artists, especially ones tattooing scars for the first time, concerns Charles Zwerling, chairman of the American Academy of Micropigmentation. He says his organization, which also tattoos scars, “combines medical correction with permanent cosmetics,” and relies upon a certification process for its members. “We might use the same instruments and the same pigments,” he said, “but the purpose and therefore the training is completely different” from tattoo artists.
But practitioners of micropigmentation don’t do design work, Zwerling emphasized.
Teryn Darling said four or five local plastic surgeons directly refer patients to her Las Vegas tattoo parlor (www.girlzink.com). Some women want the incision scar around their nipples after breast augmentation tattooed to match their skin color. Others want entire areolas tattooed back onto their reconstructed breasts, for which Darling uses a shadowing technique to give the illusion of raised skin. Those tattoos can cost between $400 and $600.
A word that invariably comes up with scar tattooing is empowerment. “Very often the scars are about something that happened to them,” said Merritt of her customers. “And the tattoo process helps them to reclaim that because it’s something that they are choosing to do with a design they want. That really shifts the focus to something that is in their control.” She added, “I feel privileged to be a part of that process.”
Rather than cover up the zig-zagged scar from her mastectomy, Jane Fox chose to have Merritt embellish it by incorporating a skeletal lizard design. She views it as a badge of honor and not something to be hidden, asking, “Why should I be ashamed because I had a disease and it didn’t kill me? Now when I hear people talk in hushed tones about breast cancer,” she added, “I always flash them and let them know my story.”