She boosts breast cancer survivors' confidence with 3D nipple tattoos: 'I love seeing women feel whole again'

Michele Khoo is not your typical tattooist. Instead of inking flowers, quotes or symbols onto your skin, the 38-year-old is an expert in tattooing nipples and areolas on women with reconstructed breasts who have lost theirs due to breast cancer. 

Called 3D nipple tattoos, these are crafted using a technique that employs the same pigments found in traditional tattoos, to replicate a life-like image and texture of the nipple and areola on the skin, although it is actually flat. 

It all started in 2015 when Khoo’s close friend fell into depression: She was in her late 20s and had been recently diagnosed with breast cancer. Following the diagnosis, she had a mastectomy and lost a breast. 

“Though she eventually survived the cancer and had her breast reconstructed, she lost her confidence and had low self-esteem because of how she looked despite her age,” Khoo said. 

Khoo, who was then a finance administrator, empathised with her friend and began searching for ways to help her regain her confidence. 

“I wanted to find out if there were ways for women to have their breasts remade with nipples,” she said. “Because even if you reconstruct them after losing them (to breast cancer), you still won’t get back the nipples.”

This led Khoo to discover 3D nipple tattoos and the paramedical practice of tattooing.

“I found out that in countries like Australia and the US, there were many aesthetics clinics by doctors and paramedics that provide tattooing services to recreate natural breast nipples,” she said. “It was exactly what my friend needed, and I got excited.” 

However, at that time, there weren’t many in Singapore who did nipple tattooing. 

“My friend and I came across a tattoo parlour that did nipple tattoos, but she, who’d never had a tattoo before, wasn’t very comfortable about doing it,” she said.

“The place had little privacy. My friend wasn’t sure if getting tattoos would work on her reconstructed breasts, and she didn’t want to bare her chest there.”

The two friends dropped the idea. But Khoo, who was still intrigued by the procedure, was moved to figure out if she could learn the practice herself.

GETTING THE COLOUR AND TEXTURE RIGHT

Then in 2018, Khoo came across micropigmentation courses in Australia. The cosmetic procedure is also known as cosmetic tattooing and is done to improve or replace lost colouring on the skin, such as those with burns or surgery scars. 

It piqued her interest enough that she enrolled in a course at the Australian Cosmetic Tattoo College in Brisbane, Australia. 

The hybrid course consisted of online theory classes that covered colour theory, skin anatomy, post-tattoo aftercare and wound healing. It would conclude with an in-person practical component with tattooing demonstrations, hands-on practice with the equipment, and the opportunity to work on patients.

“It started as a casual interest to know whether I could help my friend,” Khoo said. “But eventually, as I went for the online lessons, it became more serious and I started to consider quitting my finance role so I could start pursuing this full-time and help other breast cancer survivors, too.”

After the theory classes, Khoo took time off from work to head to Brisbane for three days of practical lessons. There, she practised her tattooing skills first on paper, then on silicone skin and finally, on real patients.

“No nipple is made of just one colour,” she said. “To make sure the nipples look as real as possible, I have to mix the colours to get the right texture and shade. This involves up to eight different pigments of pink, red, brown and yellow.” 

The first patient she tattooed was a woman who had scars on her chest from a burn accident when she was three years old. 

“The woman told me, ‘I’ve never remembered my own nipples, I wouldn’t even know how I’d look like or if this would work’,” Khoo said. 

“I was so nervous working on actual skin for the first time. I made sure to blend the pigments properly and tattoo the nipples that I thought my patient would like.”

Khoo also saw her first breast cancer patient while in Australia. “She told me she was sceptical of the procedure, and she had already given up thinking about her nipples,” she said. “But when she found out about the service, she wanted to give it a try.”

Both patients were stunned by the results. “They were so emotional when they saw how realistic the nipples looked,” Khoo said. “They kept saying, ‘It’s so real!’ and I felt so relieved and proud when I saw their reactions.” 

By the end of the fortnight, Khoo had achieved certifications in hygiene standards, aesthetic tattooing, and paramedical scar camouflage. And she was certain that she wanted to pursue paramedical tattooing and micropigmentation as a career. 

Armed with her certification, she headed back to Singapore, resigned from her finance job, and in early 2019, opened her paramedical tattoo centre at Novena Medical Centre. 

“Not forgetting why I started this whole journey, my friend became my first patient in Singapore, and I was so happy to help give her the natural look of the nipple and breast she had lost,” Khoo said.

MAKING WOMEN FEEL "WHOLE AGAIN"

When Khoo started her practice, it was hard to get patients. Such services were practically unheard of in Singapore. “I knew that women would be interested, but they probably didn’t even know I existed,” she said.

She compiled a mailing list of all the doctors she could find on the internet who specialised in breast reconstruction, in both private and public practice. 

“When I sent out the e-mails, I didn’t expect much in terms of replies but to my surprise, many doctors got back to me,” she said. “I spent a lot of time speaking with them – they wanted to know more about what I did and my certifications before they could refer their patients to me.” 

The referrals soon came in, and Khoo started to see more patients regularly.

Nipple tattoos are typically done at least three to four months after a woman goes through breast reconstruction surgery, as the time can allow the breasts to set and heal. 

One of the most popular packages Khoo offers goes for S$1,250 and consists of a consultation, a tattoo session, and as many follow-up sessions as needed to intensify or readjust the colour of the tattoo to ensure its permanence and colour consistency. 

The duration of the first session takes from one-and-a-half to two hours, while follow-up sessions for touch-ups take from one to one-and-a-half hours.  

Depending on how the tattoo pigments appear on each individual’s skin and whether it is to the patient’s satisfaction, follow-up sessions can range between two and four visits.

This year, Khoo relocated her centre to a co-working space at Anson Road. The move allows her to concentrate more on her practice, while the counter staff at the co-working space takes care of tasks like registration and administration.

In the two years since COVERS opened, she has helped close to 200 patients, most of whom are breast cancer survivors. 

“I’ve worked with women with all sorts of skin issues such as burn scars and post-surgery wounds,” she said. “They are of all ethnicities and backgrounds, and my favourite part about what I do is that I love seeing women feel whole again.

“Seeing their reactions to the treatment and nipple tattoos, and hearing them say that it’s helped them regain confidence is something I appreciate a lot.

“A woman’s body means a lot to her self-image, so to be able to work in a job that helps boost women’s self-esteem gives me a lot of fulfilment.”