Lady 49 y/o suffered from breast cancer. The reconstructive surgeon advised the patient a mastectomy right breast with an immediate Latissimus Doris reconstruction, which involves the use of a muscle flap taken from the back, beneath the shoulder blades.
To create a symmetrical areolar complex, I designed the borders, with a surgical marker, by measuring the contralateral areola to obtain the same size and shape (oval shape). I designed an identical shape on the reconstructive breast. I did not cover the scar of the reconstructed breast, because then, the (new reconstructed) areolar would look bigger then the contralateral breast. This would result in an unproportional shape on the patient’s body. Somemore, the patient herself did not want to enlarge the shape of the remaining (contralateral) breast. To cover the scar, the remaining breast had to be designed bigger to obtain symmetry with the reconstructed areolar, which the patient did not want. The positioning of the nipple has been respected.
Anesthesia : local anesthesia 2%Xylocaine & adrenaline, 5cc on each side, injected by the plastic surgeon.
Pigmentcolor : I determined the color by the skin tone, the existing color of the contralateral breast’s nipple and areolar complex. I mixed brown, cherri berri, salmon and red (Huck Spaulding Color Corp.). I add more red for the nipple procedure.
Instruments : coil tattoo machine, 11# shader, and 5 cluster
Technique : By starting at the border, the outside edge, I make sure the correct shape is in place and eventual swellling would not lead to distortion nor confusion. I do not pass a second time on the border to allow the outside edge not to be marked artificially. You obtain a washed out effect, also by adding a bit of water to your pigment. Then I move toward the nipple. I complete the second breast. For the nipple pigmentation I add red to the existing areola pigmentcolor. After the procedure, and upon the plastic surgeon’s approval, I apply Iso-Betadine to prevent infection, with compresses, bandage.
Size, shape, and color of the nipple areolar complex look very aesthetic. The plastic surgeon and myself find symmetry and balance. The patient gained self-esteem and she is very happy with the aesthetic, natural result. Sometimes it is difficult to design and to work towards a safisfying result for patient, surgeon and mpspecialist. Experience, criticism and teamwork is necessary to meet such satisfying aesthetic results.
Joëlle Senden is in the micropigmentationindustry since 1997. Joëlle Senden has had a 2-year-training with a boardcertified plastic and aesthetic surgeon in Belgium, got also trained with several leading mpspecialists in The USA, and is a board certified member at The American Academy of Micropigmentation .This wide experience allowed her to take out the best of each instructor and develop her own high level of performing and instructing. She is specialised in restoring areolas, reconstructive procedures such as cleft lip, reconstruction of unbalanced mouth in combination with Botox and Artecoll injections, color- & shapecorrections from previous micropigmentationprocedures. She created her own Art of Designing. Joëlle Senden participates regularly in charity. She has written numerous articles for industry magazines, she is instructor in different languages Beginners & Advanced level in several countries such as in France, The Netherlands, The USA.
Excerpt from “Hanna Pavilion, Cleveland, Autumn 1983” Suicide ward’s a strange place to make friends; never know how long they’ll last. Past the bend in the narrow hallway, an institutional sage-green elbow fixed at a right angle, past the plexiglassed glaze of the nurses’ station, we took turns lighting our cigarettes, our one means left: no butter knives, no nail files, no
FOOD ALLERGY ACTION PLAN Student’s Name: _____________________________ D.O.B.___________________ ALLERGY TO: _______________________________________________________ Child’s A special table for lunch/snacks is requested. ALLERGIC REACTION TREATMENT for ALLERGIC REACTION Any of these symptoms can represent an allergic reaction: 1. Injectable Epinephrine (check one) Mouth :
