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As Tattoos Become More Popular, Surgeons Are Altering Their Techniques

I’ve spent blood, sweat and way too much cash on my tattoos to have a surgeon carve through them like a turkey (but, y’know, thanks for saving my life, doc)

Eighty percent of my body is covered in tattoos. I’m intensely protective of them: I sport long sleeves in 100-degree weather to avoid excessive sun exposure; I exfoliate regularly to prevent dead-skin build-up; and I moisturize (my entire body) daily to thwart wrinkles and tired-looking skin. I even shun certain ink-endangering activities — e.g., cycling, skateboarding and woodworking — to ensure I don’t accidentally scrape off a giant chunk of skin (and with it, my prized artwork).

Because of this absurd level of protectiveness, one of my worst nightmares is undergoing a surgical procedure (minor or major) that results in the slicing and dicing of my tattoos. I’m not the only one with this fear, either: A 2009 study concluded that “tattoo disruption by surgical incision may cause distress especially in female patients who had their tattoo recently.”

And while my fear might sound irrational, it does happen: Reddit user dwitman emphasizes how upset his grandfather was after surgeons cut through one of his tattoos, resulting in a mystifying mess of ink and skin. “My grandfather, who was one of those tough old bastards who fought in WWII, had open heart surgery after his 5th heart attack. They basically folded his tattoo on itself, getting rid of about half of it and making it incomprehensible. He was pissed.”

This fear of mine may soon be put to rest, though, because surgeons have recently begun taking special care when operating on tattooed patients, at least per a 2013 review: “If a tattooed area needs to be operated on, surgeons should attempt, when possible, to avoid altering the tattoo in order to maximize the final cosmetic result.”

How that’s done, however, remained somewhat of a mystery, so I reached out to board-certified plastic surgeon Sheila Nazarian to discuss how she ensures patients leave the operating room with their tattoos intact. “Sometimes I’ve had to cut through tattoos — say, to remove a cyst,” Nazarian explains. “When I’m sewing that area back up, I have to take care to realign the tattoo exactly how it was before.”

But what if it’s not quite that simple? For example, I have an extremely meticulous snake on my belly, and I’d like for it to look exactly the same if I ever undergo stomach surgery. “Just last week, I performed a tummy tuck on a patient who had a tattoo just below her belly button,” Nazarian says. “With her, I couldn’t save all of the tattoo, but my concern at that point was keeping it symmetric to ensure that the midline of the tattoo was aligned with the midline of her belly when I sewed her up.” So at least, even if it’s not what it once was, it’ll still look mostly respectable.

Still, sometimes the tattoo simply can’t be saved. “Months ago, I operated on a famous singer, and she had a tattoo on her arm (I was performing an arm surgery on her to take out some of the extra skin on her arm),” Nazarian says. “I ended up removing the tattoo completely, because it was right in the way. I’m never going to compromise outcomes in contour to avoid cutting into a tattoo.”

Well that SUCKS.

But I shouldn’t freak out just yet: If a surgeon has to dismember your body art, artists can tattoo directly over surgical scars that have been given enough time to heal. “I usually make my patients wait about two months (at minimum) before I allow that to happen — typically I advise they wait six months,” Nazarian emphasizes. “That’s because the scar is still remodeling during that time: Three months is when scars are normally the thickest, as well as the most angry and red. You want the scar to be at its flattened-out stage before tattooing over it.”

Hey, whatever saves my tattoos.