Medical and Cosmetic Application of Tattoo

1. 8th WIN n’ LEARN
Cosmetic and Medical
Applications of Tattoo
Presenters: Jacqueline Kihwele
Lutfi Abdallah

2. • Humans for generations have used tattoos for
a number of reasons which serve as marks of
status and rank, symbols of religious and
spiritual devotion, decorations for bravery,
sexual lures and marks of fertility, pledges of
love, punishment, protection, and as the
marks of outcasts, slaves and convicts.
• There is evidence that tattoos were used for
medical reasons.

3. The American Academy of Dermatology
distinguishes 5 types of tattoos:
1. Traumatic tattoos, also called "natural tattoos"
2. Amateur tattoos;
3. Professional tattoos, both via traditional methods
and modern tattoo machines;
4. Cosmetic tattoos;
5. Medical tattoos.

4. Reconstructive and Cosmetic tattooing
Areolar reconstruction
• Breast reconstruction after mastectomy is
fundamental to the psychosocial health of the
patient and helps her regain a positive body
image.
• Tattooing of the nipple-areola complex is
usually the final step of the breast
reconstruction process.

5. Bilateral mastectomy with delayed expander/implants reconstruction,
and nipple areola tattoo
Source: http://www.northwesternplastics.com/baBreast-Reconstruction.html

6. Tattooing as camouflage
• Tattooing is used to repigment the skin in conditions
that cause hypopigmentation or hyperpigmentation
including burns.
• It is also used as an alternative to laser treatment in
port-wine stain and in cosmetic surgery of the scalp.
• Tattooing is used for micropigmentation of the lips and
fingertips in patients who have vitiligo. However, this
should be reserved for those with stable vitiligo, since
tattooing may trigger another patch of vitiligo at tattoo
sites.

7. • Although medical management exists for
vitiligo, it is often ineffective for lip vitiligo
since the success of medical therapy depends
on the pigment-cell reservoir at the site of
depigmentation.
• The lips lack such a reservoir of melanocytes,
so tattooing may be an option.

8. Vitiligo Depigmentation Skin Camouflage
Source: http://www.artisticcosmeticsolutions.com/scar_camo.html

9. Tattooing to hide surgical scars
• decorative tattooing to camouflage
cosmetically undesirable scars
• It is a valid option, especially in younger
patients, among whom tattooing is common
and acceptable.

10. Cleft Lip Surgery Scar Camouflage
Source: http://www.artisticcosmeticsolutions.com/scar_camo.html

11. Corneal Scarring,
• Perforating injury, measles keratitis, and other
conditions can result in cosmetically
disfiguring discoloration of the cornea.
• When microsurgical reconstruction is
ineffective or is not an option, corneal
tattooing has been reported to provide
satisfactory results at up to 4 years.

12. Left (A) central scar after perforating injury in childhood, Right(B)
mature cataract Result immediately postoperatively after
tattooing a pupil.
Source: Pitz S, Jahn R, Frisch L, Duis A, Pfeiffer N. Corneal tattooing: an alternative treatment for disfiguring
corneal scars. Br J Ophthalmol 2002; 86:397–399.

13. Patient with visible corneal opacity on the left and tattooed
cornea on the right. The process was done in conjunction with an
Ophthalmologist when he rejected corneal transplantation and
contact lens.

14. ‘Permanent makeup’
• Permanent makeup is the use of tattoos to
enhance eyebrows, lips (liner and/or lipstick),
eyes (liner), and even moles, usually with natural
colors, as the designs are intended to resemble
makeup
• tattooing may be beneficial to people with
allergies to conventional makeup or with
disabilities that make applying makeup difficult

15. Permanent make up drawn to enhance eyebrows, lips (liner
and/or lipstick), eyes (liner).
Source: http://www.phundeals.com/deal/detroit/200-500-permanent-makeup-
bloomfield-esthetics-7

16. Medical application from history
Ötzi is a mummified human discovered in 1991
in the Schnalstal glacier in the Alps, on the
border between Austria and Italy. He died
around 3300 BC.

17. • Medical tattoos has been used in the ancient
times for several purposes, the major use was a
therapeutic, such tattoos has been seen in Ötzi
the Iceman, has several tattoos, concentrated at
joints: parallel lines on the right foot and ankle,
bars along the lower spine, lines on the left calf,
and crosses inside the right knee and left ankle.
X-rays revealed chronic degeneration of bone and
cartilage in the spine and arthritic wear and tear
of the knees and ankles, suggesting the practice
of the ancient folk remedy of tattooing to relieve
pain.

18. MEDICAL ALERT TATTOOING
• Medical alert tattooing is a form of medical
identification similar to medical alert jewelry,
i.e. bracelets and necklaces, to alert first
responders to a medical condition or to
specific desires for care, such as do-not-
resuscitate (DNR) directives.

19. • New phenomenon (practiced by the patients on
their own without medical consultation can be
found on the internet).
• These practice are seemingly underreported in
the medical literature with its advantage and
potential drawbacks.
• E.g. A woman with a tattoo warning of a past
severe reaction to succinylcholine during
anesthesia. She had been advised to wear
medical alert jewelry, but she instead chose a
tattoo.

20. Medical warning tattoo drawn just below the wrist of the diabetic patient
Source: http://www.medicinenet.com/tattoo_pictures_slideshow/article.htm

21. Pathologist Dr. Ed Friedlander on the left and Dr. Albert Cutter M.D display
their tattoo with a medical directive to not use CPR.
Source: http://www.ctvnews.ca/medical-tattoos-offer-important-health-information-1.774009
http://www.aarp.org/health/conditions-treatments/info-06-2012/medical-alert-tattoo.html

22. Organ donor tattoo
In the case of a person who had his consent to
be an organ donor tattooed on his chest or
other part of the body, the tattoo was viewed as
not equivalent to signed documentation

23. Source: http://ttelroc.blogspot.com/2011/05/caregiver-tattoos.html

24. RADIATION ONCOLOGY
• Tattooing is used in radiation oncology to
ensure accurate targeting of radiation therapy.
• Typically, several small, black marks 1 to 2 mm
in size are applied by a medical professional
using an 18- or 19-gauge hypodermic needle
and india ink.

25. Tattoo on the chest of the patient on the final treatments of the
breast cancer which mark the outline of the plate
Source: http://nancysbreastcancerjourney.blogspot.cz/2012_07_01_archive.html

26. ENDOSCOPIC TATTOOING
• In laparoscopic gastrointestinal surgery, lesions
are often difficult to visualize and localize since
the surgeon is unable to palpate the bowel
directly to identify the diseased segment; this
increases the risk of resecting the wrong segment
of bowel.
• Endoscopic tattooing of the segment to be
resected greatly improves the accuracy of
laparoscopic procedures.

27. The serosal appearance of the non palpable colonic lesion
marked with india ink (black stain) as seen during laparoscopic
resection
Source: Willium & Wilkins, Baltimore p.55

28. FORENSIC MEDICINE
• Specialists in forensic medicine use primary
markers such as fingerprints and dental
records and secondary markers such as
birthmarks, scarring, and tattoos to identify
victims.
• Tattoos are useful for identification when
fingerprints or dental records are unavailable

29. Tsumani ocean waves on the left and devastation caused from
the air on the right
Source: http://esl-bits.net/listening/Media/2011-06-16/Tsunamis/
http://news.nationalgeographic.com/news/2012/04/pictures/120412-indonesia-tsunami-earthquake-science-
world/#/2-tsunami-flooding-destruction_51402_600x450.jpg

30. • However, as the body decomposes, tattoos
can discolor and fade, making them hard to
identify. Application of 3% hydrogen peroxide
to the tattoo site has been reported to aid in
identification, and infrared imaging has shown
promise.

31. “21st Century Medicine , think broader , think
three dimensional”
Thank you