Tattoo post surgery?

January 25, 2013 8:26 AM

I recently had reconstructive surgery on my leg. How long should I wait before I get a tattoo, or should I ever?

I had a parosteal osteosarcoma removed from my femur in October. Because they had to take out part of the bone to do so, I was the recipient of an allograft (yay for being part zombie!) At this point, I'm mostly healed, although from what I understand, it can take 2-3 years for the donor bone to incorporate into the existing bone.

So, I'd like to get a tattoo. The location would be on my left foot, so not on top of the scar or anything. When I asked my surgeon, I think he thought I meant directly on top of the site, and said that there was a risk of infection, and he wouldn't recommend it. But he also said he hadn't read any literature about it, so he wasn't sure. So Mefites, how risky is it? Should I bother at all? Would it be safer if I waited some amount of time?

posted by bluloo to health & fitness (10 answers total)

you're talking about a tattoo far away from the surgery site, right? I would only worry about being more prone to infection in general. I would make an appointment with a gp and talk about the possibility of infection and go in armed with all the information risks associated with tattoos in general- and ask about how each individual risk could be affected by your current health status. Like, "in an average person, the risk for a poor reaction with the ink is X, could i be at more risk for that because of the surgery? would it matter if the tattoo site was say, on my shoulder?"
posted by Blisterlips at 8:49 AM on January 25

I would be more concerned about getting a systemic infection than a localized infection, though both are possible with a new tattoo. Your body is currently trying to restructure itself- why willingly expose it to another challenge? At this point, and for the next few years until the allograft is resorbed, you are still at risk for rejection (up to 35% risk depending on the study you look at). Tattoo artists will still be around in a few years, just wait. Give your immune system a rest and try not to get into situations that might trigger huge immune responses.
posted by PorcineWithMe at 9:02 AM on January 25 [4 favorites]

A fresh tattoo is an open wound that is vulnerable to infection, similar to a burn. If your tattoo gets infected, that could potentially interfere with the healing of your allograft. If you don't have normal use of your leg yet, you might have decreased circulation in your foot which could put you at higher risk of infection. I would wait until the graft is pretty well healed before getting a tattoo.
posted by keep it under cover at 9:09 AM on January 25 [1 favorite]

There is not much literature on post-transplant tattooing - I wasn't able to find any at all when I last looked. It's a niche area and doctors probably aren't going to conduct an RCT on transplant patients to see if tattooing is safe.

That said, anecdotal evidence suggests it is ok, as long as you care for the tattoo site properly. Googling for this reveals plenty of post-transplant recipients on heavy immunosuppressant drugs who get tattoos and don't get skin infections. Heck, I'm one of those people myself.

I would wait a year or so to see how your body responds to infections generally before proceeding.
posted by k8lin at 9:09 AM on January 25

I wanted to get a tattoo post-chemo after, as a victory lap of sorts. My surgeon and oncologist both said to wait at least 6 months for my immune system to bounce back to be safe and make sure I wouldn't need an MRI just in case. The tattoo artist I worked with also agreed with waiting because he wanted to make sure my body could heal properly. That's not really the same, but it's all to say if your immune system is back to normal, it should be OK. Waiting can't hurt anything.
posted by kendrak at 10:07 AM on January 25

This question should be discussed with your doctor.
posted by Ruthless Bunny at 10:21 AM on January 25

Ruthless Bunny, as I stated in the original post, I did discuss this with my surgeon/sarcoma specialist. He just didn't seem informed about the issue. I do intend to address it again in the future follow up appointments though.

Thank you for the informative answers. For a little more info, I am not on any immunosuppressants or ongoing medication of any kind. I am also fully functional at this point, so decreased circulation isn't a concern.

That being said, I have no problem waiting. I just wanted to make sure it was something that would be an option down the line, as opposed to never.
posted by bluloo at 10:49 AM on January 25

IANAD, but I've been through total hip replacements on both legs due to AVN. After major orthopedic surgery in your legs or arms, you are at higher risk for post-surgical complications like lymphedema for at least several years. The best strategies for avoiding some of these complications is to avoid further injury, and even undue wear and tear to the limb, until it has recovered as much normal function as it will, and this may even extend to additional protection from heat and cold conditions that never bothered you before. And, the less you do to yourself outside normal recovery and rehabilitation, the "cleaner" your medical situation will remain, and thus, the more likely any complications will be soon recognized, and treated. You may not want to "baby" that leg, but for a good long while into the future, you'd be very wise to respect the surgical investment that has been made in it, and in your future mobility, and pay due care and attention to it.

If your surgeon is unable/unwilling to speak to your question directly, you can ask for a referral to someone else who might be better able to explain your near and long term post-operative risks, and guide you as to further elective procedures like tattoo. Ultimately, it's likely to be left to you, and I have also known two women who went through mastectomy procedures with immediate breast reconstructions, who had a "nipple" tattooed back on the reconstructed breast within weeks of surgery, despite lymphedema developing in their arm on the operative side, before the tattoo procedure was started. It was just so important to them to have the appearance of normalcy after their surgery, that they accepted the increase in risk that tattoo represented to their already surgically challenged lymph system on that same side. But I think both would tell you now, at some years of remove in time, that it was vanity, not wisdom, that ruled their decisions.

Good luck with your continued recovery.
posted by paulsc at 10:53 AM on January 25 [1 favorite]

Just in case your doctor hasn't talked to you about this general, as well as specifically in regard to a tattoo, I believe you may need to take more precautions than a non-allograft individual with regard to any procedure that could result in infection. THis site speaks specifically to metal/plastic implants: http://orthoinfo.aaos.org/topic.cfm?topic=A00629

The issue is that 'normal' individuals can risk having a certain number of bacteria, etc. present in the sterile parts of the body (blood, joints, etc.) and still have a low risk of infection. With an implant present, the risk of infection goes up a lot; the threshold for how many bacteria need to invade in order to cause an infection drops dramatically. This is why people with knee replacements typically take antibiotics before dental procedures; a normal person can risk the bacteria entering the blood stream and fight them off with the immune system. The person with the implant is much more sensitive to a low number of bacteria....

What I don't know is how the risk that is inherent to plastic/metal implants relates to allograft tissue. But your doctor should or should be able to refer you to somebody who does.
posted by Tandem Affinity at 1:52 PM on January 25 [1 favorite]

I know you've already marked best answer, but I wanted to let you know if you have nerve damage on the leg you had the surgery on, getting a tattoo might hurt more than you would expect...
posted by mgrrl at 3:56 PM on January 26