When Karen Betts found out that her close friend had breast cancer, she knew that she wanted to do everything in her power to help restore her confidence. Like thousands of other women in the UK each year, Karen's friend had a mastectomy following her diagnosis. Struggling with the aftermath of the operation, she felt as though she'd lost her femininity, admitting to Karen that she couldn't bear to look at herself in the mirror.
As a trained professional in hair and beauty, Karen owned her own salon, so she decided to give her pal a treatment that hardly anyone else offered at the time. She told The Mirror: "I had a tattoo artist who rented a room in my hair and beauty salon, so I went and got his tattoo machine and I tattooed her some eyebrows and some areolas."
Explaining the lightbulb moment, Karen continued: "I just thought: it would look great if I tattooed her some areolas. So I got some magazines out, had a look at what areolas really look like, and I created the effect of real-looking, 3D nipples.
"I made my friend feel so much more confident after the treatment, and I thought: this is amazing. This is something I need to do for more people. So that’s where the journey started."
More than 20 years on, Karen has tattooed thousands of nipples on women who have had breast cancer. She is now an industry-leader in cosmetic tattoo work, running her own permanent make-up company, K.B Pro, as well as a training school to help other people looking to empower women through permanent make-up.
"This wasn’t something that tattoo artists were offering in the UK at the time," the artist explains, "so I went out to the States and trained to do the cosmetic work in a basic way, then taught myself the rest. I started my business up and then began teaching lots more people how to do it five years later."
Karen's friend wasn't alone in suffering with low self-esteem after a mastectomy, as research shows that the surgery can have a negative impact on a woman's body image. One study by Yale School of Medicine found that mastectomies can "change women’s feelings about themselves, comfort with social interactions, and willingness to engage in physical intimacy".
"Women undergoing chemotherapy showed a reduction in body image and were anxious regarding hair loss and other possible side effects compared to women with cancer who were not having chemotherapy," the report added.
Given that around 14,850 of the 55,000 women diagnosed with breast cancer each year in the UK undergo a mastectomy, Karen is looking to raise awareness around just how transformative permanent make-up treatments can be, as she believes many women have no idea how authentic the results can look after just a couple of sessions.
Commenting on the moment that she decided to tattoo her friend's areolas, Karen said: "My friend just burst into tears. The difference it made in the way she felt about herself was huge. It made her feel whole again, as if she’d got her femininity back. She felt pretty again.
"Having no eyebrows and losing her areolas meant that she didn’t want to look at herself in the mirror. Now she could see herself and feel like a woman again."
"Women who have had a mastectomy after breast cancer have gone through so much surgery that by the time they get to me and by the time I’ve done the treatment, I get all the tears," she revealed.
"It's the surgeon who saves their lives but I just make them feel like a woman again, and feel better about themselves. It’s very emotional as it’s the end of their journey. They feel like they can finally move on now".
The cosmetic specialist explains that some women get 'perfect results' after just one session, but she will always book two treatments in to achieve the realistic finish for clients.
"It’s unbelievably rewarding. People come in with low expectations and I overachieve completely, because they don’t ever realise that it can look as real as it does when it’s healed," Karen says.
"We use light and dark shading which makes the nipple look like it's protruding, and we add the look of those little white glands in there too. If it's only one nipple, we’ll look at the woman's other areola and completely mimic it to ensure it's the same size. We can put colour in any of the scars as well.
"These are treatments that not everyone knows are out there and I want everyone to know about them because they make such a massive difference to people's confidence and self-esteem."
Karen says that people are in 'utter disbelief' at the results of the tattoo work, and they feel far more comfortable showing their bodies afterwards as their self-esteem skyrockets.
" When I show people the transformation in the big mirror, they'll say 'wow, I can’t believe it'. They see a massive difference when I've drawn them on but once I’ve tattooed it they are in complete shock".
Aside from working on re-creating the appearance of nipples post-mastectomy, Karen explains that one of the most rewarding treatments for women who have had breast cancer is permanent eyebrow tattoos, as it can completely transform how they feel about themselves.
"A lot of people who undergo chemotherapy can accept losing their hair as you can get a wig or a hair piece, but losing their eyebrows makes them feel like they are losing their identity. So it can make a huge difference."
"I always say for anyone who is about to have chemotherapy, book in with a permanent make-up artist before you start your treatment. We can put some colour in beforehand and work around their natural eyebrows, so once they start losing them it doesn’t feel like such a shock," she explains.
Although cosmetic work can be a huge help in empowering women after cancer, Karen says that rebuilding confidence has to come from your inner-self too - she recommends positive affirmations for women struggling with their self-esteem.
"Most of the time, we underestimate the power words have in our lives, especially the ones we say to ourselves. Recovering from something such as breast cancer can take a toll on your mental health as well as all the physical changes to your body. So affirming positive ideas about our bodies as we heal is vital, and can be key in the quest of feeling sexy again."
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