Author: Cassandra Ellis

“You made me feel real again.”  That’s often the response when tattoo artist Mandy Sauler works with clients who have recently been through breast cancer treatment.  Her office is often the last stop in a long journey of treatment and recovery.  Sauler specializes in 3-D nipple tattoo reconstruction for women who have had reconstructive surgery, making breasts look more natural for survivors.

“They look in the mirror and their mouth just drops open and they’re back to normal,” said Sauler.  She has been an artist for more than 17 years.  Sauler learned from her mother who owns a tattoo shop in Downingtown.  For the past 7 years, she has focused on the cosmetic side of the art through tattooing eyebrows or hair.  When she found her focus, Sauler discovered the need for nipple tattoo reconstruction and the process became effortless.

“Doctors had been doing the procedure before, but now tattoo artists are working on making them look more realistic,” said Sauler.  “When they look in the mirror, they have a focal point.  The focal point takes away from all of the other scars, you almost don’t see them anymore.  They fade away in the background.  It’s amazing what you can do with something so little.”

Sauler says there are still many women who end their recovery process without going through nipple reconstruction.  She wishes more survivors knew that the tattooing is healed within days, there is no down time, no restrictions and no pain with the help of anesthetics.

Two days a week, Sauler works with breast cancer survivors at the University of Pennsylvania Abramson Cancer Center.  She also works out of her offices in Plymouth Meeting and Exton and frequently travels to Manhattan.

Sauler’s Web site shows before and after pictures of breast cancer survivors taken after their 3-D nipple reconstruction.  If you would like to see the photos or learn more about Sauler’s services, click here.

By Stephanie Stahl

PHILADELPHIA (CBS) — Ashamed, embarrassed are just two of the emotions that some men experience while losing their hair.  But we’re going to let you in on a little bit of a secret.  There’s a simple, permanent procedure that can give you an A-list look.

Hair challenged men have a new alternative.

“Once we had hair, now we don’t.  We just want it back,” said Orian Barzily, who was balding.

They’re not  getting back  actual hair, but it might look like it thanks to a procedure called micropigmentation.  Tattoo artists apply small dots to the scalp.

“It’s a 3 point micro needle.  It’s very fine,” said Orian, who is also a micropigmentation practitioner and had the procedure too.

“It’s an ink we apply to the head to make it look like men have hair,” said Julissa Rosado, who works at micropigmentation clinic.

It creates the look of a closely shaved head, popular now with Hollywood celebrities like Bruce Willlis, Vin Diesel, Jason Statham and Pitbull.

“I’ve gone through four hair transplants, over $30,000 down the drain on procedures that didn’t take.  This is the only thing that worked.  Before that I lived under a hat.  Now my hats decorate my walls,” said Orian.

“It’s almost like a five o’clock shadow.  You’re kind of doing little microdots, and it just makes the hair look fuller and thicker,” said Mandy Sauler, the micropigmentation specialist at Penn Medicine.  Many of her clients are cancer patients, who’ve lost hair.  She does a lot of eyebrows, and other cosmetic tattooing, that include things like eyeliner, even covering up scars and filling in bald spots.

“I think what I do with micropigmentation is bringing back things that people had before or making life easier.  It’s really amazing what we’re able to do,” said Mandy.

“Here is me a little bit in the back is me as well, but the front and the side are not me,” said Anthony Castigli, a 21-year-old who started losing his hair at 18.  He says micro pigmentation changed his life.

“I wanted to look at myself and say ya know I just, to feel confident and not hate what I see in the mirror,” said Anthony.

The procedure can take two to three treatments.

There is a small risk of infection.  The tattoo needles do pierce the skin, so it can be uncomfortable.  The cost to fill in the scalp can range between $1,600 and $5,000.

Penn Medicine Micropigmentation Information- http://www.pennmedicine.org/plastic-surgery/cosmetic/skin/micropigmentation-permanent-makeup.html  and http://www.pennmedicine.org/providers/profile/mandy-sauler

Unique Jobs at HUP

Most health-care jobs have a clear connection to medicine but others are not quite so obvious. Read below to see how a tattoo artist uses her skills to help cancer patients.

When Mandy Sauler starting doing tattoos in her mother’s shop nearly 20 years ago, she never thought this skill would lead her to helping women recovering from breast cancer…. But that’s exactly what happened. As HUP’s micropigmentation specialist, she provides the final step for many women who underwent mastectomy and reconstructive surgeries, tattooing areolas to create a realistic three- dimensional appearance. 

Many factors combine to make a natural-looking areola, Sauler explained. If the patient has a unilateral reconstruction, Sauler matches the tattooed areola with that of the remaining breast. But, with a dual reconstruction, she discusses with patients the best size and coloring for them now. For all tattoos, “I draw it on first to see how it looks in the mirror,” she said. “Then I mix up colors based on their skin tone and see how it looks on the patient’s skin.”

Once she and the patient are satisfied, she begins the tattoo process, using different-sized needles and multiple colors to create the desired effect.  Although most women don’t feel any pain, “I can use topical anesthetic,” she said. Most tell her, “It wasn’t as bad as I thought.”

Some patients have a nipple created surgically but, for others, Sauler can create the illusion of a 3-dimensional nipple, which looks extremely lifelike. One woman wrote her a letter about when she went for a mammogram for her “new” breast: “The clinician, who does 20 to 30 mammograms a day, pulls a ‘marker’ off a strip and plants it right on the tattoo you gave me (my new nipple)…. The woman thought it was a genuine nipple at first glance.… I said, ‘That’s a tattoo’ and she was floored! She said that’s she’d never been fooled before. A heartfelt thanks for a job well done!”

When the process is completed, “I stand behind the patient as she looks in the mirror. Looking at their faces – it makes me feel so good. No one has a better job than I do.”

Sauler began her early training working on oranges. “I was eager to learn so my mom would have me practice on oranges or grapefruits. At the time, they were perfect because of the thickness of the skin and they’re round, like the curvature on most body parts,” she said. When she was 14, “I started saving the tattoos – in the freezer – to show friends!” Today, she said, tattoo artists can learn on fake skin or mannequins, which were not available back then.

To become skilled in medical tattoos, Sauler trained “with a medical tattoo artist who is also a painter,” she said. Medical tattooing has become a little more common, but early on, medical offices were given a machine to create the areola “which had some basic skin colors but they received no training. It looked like a flat circle,” she said “Now people realize it’s an art. I think it takes a least three years before a person can be comfortable working on skin – and be good at it.”

Sauler uses her skill to help other types of patients as well. For example, she can create eyebrows to frame the eye for patients with alopecia (which causes hair loss on some or all of the body). She can also camouflage scars. She recalled one person whose leg was seriously burned when she was a toddler and had always worn slacks to hide the scar. “Over time scars hypopigmate, which means they turn lighter,” she explained. Using multiple colors, Sauler camouflaged the scar. “She told me that she can now wear skirt and stockings.”

Do You Have A Unique Job?

Do you — or someone you know at HUP — have a job that seems unique in a health-care setting? If so,  please let me know. Email sally.sapega@uphs.upenn.edu.

Photo caption: Mandy Sauler carefully creates an areola tattoo on breast cancer patient Ginka Nikolov.