Leaving a Mark
Tattooing is no longer just a way to express yourself. Paramedical tattoo artists like Elsa Milani are rethinking ink as a means to help cancer thrivers love their bodies.

There is no handbook for how to navigate life post-treatment for breast cancer thrivers, so many are left to research and investigate resources, communities and health treatments on their own. One such treatment, permanent makeup, continues to quickly rise as a supplemental service for life post-mastectomy. And Elsa Milani of Flawless Permanent Makeup by Elsa Milani is one of the best in the business.

Permanent makeup is a form of tattooing. Most people who get permanent makeup focus on areas like the eyebrows (known as microblading), eyelids or lips. But more and more people are using the service as a means of addressing scarring. That certainly was the case for Milani.

Milani has been in the beauty industry since high school when she earned her cosmetologist license. Back then, she largely stuck to hair and cosmetic makeup. It wasn’t until a personal tragedy that Milani made the switch.

After getting attacked by a dog, Milani had two reconstructive surgeries on her face that left her with scarring and an asymmetrical lip line. She pursued permanent makeup to fix her scarring, receiving scar camouflage and lip tattooing. “I looked like myself again,” Milani says. “That’s what inspired me to get out of cosmetic makeup and hair and learn permanent makeup. What happened to me inspired me to learn the craft.”

She made the switch eight years ago, learning “everything,” including lips, eyes, brows, and later, scar camouflage, scalp pigmentation for people losing their hair and 3D areola work. She was also inspired by seeing her grandmother, who had peritoneal cancer, pass away.

Milani currently has three certificates in areola tattooing and two in scar camouflage, and she currently also trains others in permanent makeup and scar camouflage. Through shops in Chicago and New York City, Milani has made a name for herself through her paramedical tattooing.

Thrivers interested in the procedure must be in remission and off of chemotherapy for at least 12 months. They’ll also need doctor’s permission ensuring that they’re okay and their immune system is stronger. Then, they’ll attend a free consultation with Milani, who will go over the size and color. Milani then draws the areola and nipples, measuring everything for accuracy. Once the thriver approves, the procedure is booked for a later date.

As someone who intimately knows the life-changing benefits of permanent cosmetics, Milani aims to bring that same sense of relief and confidence to people everywhere.

During the procedure, Milani numbs the area topically, re-measures everything based on the discussions during the initial consultation and custom blends the colors to recreate the areola. Creating a custom appearance is key, Milani says, to making the finished tattoo realistic. “It’s all about shading it properly and highlighting it properly to give it that 3D illusion,” she says. “You have to touch it to not know it’s real.” Most thrivers choose to get both areola tattooing and scar camouflage as mastectomy surgery often leaves white scarring on people’s bodies.

Sessions last about two to three hours and thrivers should return six weeks after their initial treatment to see how the tattooing has healed and if they need a free touch up. Radiation, for example, may make it difficult for the work to take the first time. “It is a tattoo, so they should be good for five plus years before they need to come in for a touch-up,” she says. Like any tattoo, it will fade and the color will change over time.

Making her services affordable is important to Milani. Compared to her other permanent makeup offerings like brows or lips, areola and scar camouflage is heavily discounted. “I’m not just catering to the upper class,” she says. “I want to be able to help all women who have suffered from breast cancer and need to have those areas restored.”

If one can still not afford Milani’s services, she has also partnered with Sharsheret (featured in issue 4). The organization, a Jewish breast cancer nonprofit, works with the thriver’s medical insurer to pay whatever costs are not covered. The procedures are also heavily discounted for the organization so the organization can afford it. “I’m not really making much, but it’s important to me to give back.” Milani also offers three free areola treatments every October for Breast Cancer Awareness Month and free scar camouflage treatments monthly throughout the year.

But more than anything, what is most important to Milani is making her customers feel good. As someone who intimately knows the life-changing benefits of permanent cosmetics, she aims to bring that same sense of relief and confidence to people everywhere. “I just want them to feel good. I just want them to feel confident again when they look in the mirror when they’re naked,” she says. “I just want them to feel like their old self and be proud of the journey they’ve gone through.” After all, they were warriors, now thrivers, with the “battle wounds” to show for it.

“I can’t imagine being sick, losing your hair and losing your breasts, that part of you taken from you,” Milani says. “So to be able to give that back to someone is very rewarding.”

To learn more about Elsa Milani or to book her services, visit To learn more about Sharsheret, visit


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