Applications of Medical Tattooing: A Systematic Review of Patient Satisfaction Outcomes and Emerging Trends

Abstract

Background Medical tattooing is often applied in the context of plastic, aesthetic, and reconstructive surgery to help achieve the best cosmetic outcome. Objectives This article reviews various conditions that medical tattooing have been empirically studied in terms of patient satisfaction outcomes; makes practice recommendations; and suggests future directions for research. Methods This review was performed following the PRISMA guidelines. Studies were included if the tattooing application was associated with a medical condition and if outcome data was provided using at least a case series methodology. Where no cohort or clinical series exist, case examples are used from the literature and the author’s practice to illustrate emerging medical tattooing applications that need further evaluation. Results Eighteen studies met the inclusion criteria and were applied to the following conditions: baldness, vitiligo, scars from incisions, lacerations or burns, and nipple areola complex reconstruction following breast surgery. Conclusions The application of medical tattooing has shown high levels of patient satisfaction across various conditions. The practice recommendation grade is “B” or recommend since the level of evidence for these interventions ranged from III to IV according to the ASPS guidelines. This means clinicians can consider this treatment alternative, but they should be alert to new information and be sensitive to patient preferences. Recommendations are made for reporting future research including clearly describing procedural details, identifying the professional performing the procedure, increased use of standardized outcome measures, and that satisfaction ratings be assessed by someone independent of the health service provider. Further research using RCT methodology with waitlist controls is needed.

The Application of Medical Tattooing in Cosmetic Breast Surgery

“…The literature indicates that medical tattooing for several specific disorders is empirically supported in terms of patient satisfaction with outcomes. 13 Other recent studies show the beneficial impact of medical tattooing on patient body image and psychosocial functioning. [14][15][16] Applications of medical tattooing are expanding, and the field needs professional direction.…”

Patient-Reported Outcomes of Medical Tattooing for Capillary Malformations

“…Infections, inflammatory tattoo reactions, scars, ink blow-outs, and neoplasms may occur after MT [ 28 – 31 ] but have been hardly reported [ 10 , 17 ]. Our findings show that, apart from transient pain during MT, patient-perceived complications are not severe and uncommon.…”

What about Decorative Tattoos? The Human Body in Heaven

“…68 Although the morality of decorative body modification in general is beyond the scope of this article, the distinction between mutilation and amputation is important for the issue of the eschatological preservation of tattooing. Since decorative tattoos are not undertaken for therapeutic purposes, 69 they inevitably fall into the category of willful mutilation practices, and thus violate the nature of 'our largest but also our least known organ.' 70 Although tattooing does not actually violate a natural function of the skin, except in certain cases of medical complications, skin was not created to carry decorative holes or imagery.…”