True||After defeating breast cancer with a double mastectomy and rounds of chemotherapy, 53-year-old Claude Alam felt like a fighter. And when she decided to tattoo over her scars, she transformed her traumatic memories into art.||

DIKWANEH, Lebanon: After defeating breast cancer with a double mastectomy and rounds of chemotherapy, 53-year-old Claude Alam felt like a fighter. And when she decided to tattoo over her scars, she transformed her traumatic memories into art.

“After the surgery, I accepted and appreciated my body for surviving everything it went through,” Alam says, recalling the long months in 2009 that changed her life.

“But during the recovery period, I slowly started to hate it. I was gaining weight and my breasts looked ugly. I tried to fix my chest with many operations.

“None of them worked to cover the scars left behind.”

Then Alam found Joa Antoun.

Antoun, a 28-year-old tattoo artist in Metn’s Dikwaneh, was rocked at the end of 2017 when doctors thought her mother might have breast cancer. Antoun’s mother was lucky – a biopsy confirmed her to be in good health.

Still, the scare had a permanent effect on Antoun. The transformative experience would eventually connect with her to Alam and heal two emotional wounds at once.

When her mother was facing a possible diagnosis, Antoun says, “I did a lot of research to understand the cancer.”

“Looking at all the scars, the nipples that were disfigured or completely removed from many survivors made me want to help.

“As a woman, your chest is a great part of your femininity. To have these scars can really be traumatizing,” Antoun says.

Thus began her research into “3D nipple tattooing,” a tattooing technique that creates a realistic image of a nipple for breast cancer survivors, uncommon in Lebanon but more widely available in the U.S. and Europe.

Antoun reached out to certified international tattoo artists, particularly those specializing in 3D nipple tattooing, to master the technique.

After training, the young artist decided to start offering the service to breast cancer survivors for free.

While some have come to her requesting new nipples, others, like Alam, have preferred to cover up the scars with other designs, which Antoun also does for free.

“When my children told me about what she was doing, I met her and straight away fell in love with her big heart,” Alam says, praising the effect of Antoun’s work on her self-confidence and mental health.

“She changed my mood, my temper and my soul with the art.

“I adore her work on my body. God knows how much I appreciate her soul,” Alam says.

In the past year, Antoun has already worked with over 15 women, offering her service via social media and connecting with breast cancer awareness organizations.

“While many of these women might not be on social media, their children, nieces and nephews are.

“There are so many breast cancer survivors in Lebanon that I haven’t had to work too hard to reach out to who might want a reconstruction.”

Alam was only 43 years old when she was diagnosed.

To compare, the median age of diagnosis is 62 in the U.S., and in Lebanon, women are normally diagnosed at around 52 years old.

Despite her vigilance and having yearly checkups, Alam was diagnosed only after the cancer had severely spread. Her story is one that is shared by scores of women in Lebanon, a country that has high rates of breast cancer, particularly among younger women.

In 2015, the Health Ministry reported that there were 2,473 new cases of breast cancer each year.

According to Dr. Hazem Assi, a professor specializing in oncology at the American University of Beirut, the figure, created by a multiyear average, translates to a third of total cancer cases for women in Lebanon.

In September, another study conducted by the International Agency for Research on Cancer and the World Health Organization said that 3,219 cases of breast cancer were diagnosed yearly in Lebanon, based on a multiyear average.

The report also found Lebanon had the sixth-highest incidence of breast cancer in the world, at 97.6 cases per 100,000, and that the mortality rate shot up past all other countries, at 26 per 100,000.

“We do not know the exact reasons for increased cancer risk in Lebanon, but several factors are hypothesized to be culprits,” Assi says. “First, we should not forget the inflow of Syrian refugees ... that may affect the [WHO] survey.

“Second, the region is more exposed to environmental factors: pollution, biologic toxins and high smoking rates ... a major risk factor for malignancy.”

Fortunately, the worrying statistics on breast cancer are on the Health Ministry’s radar. In 2013, a national breast cancer awareness campaign was launched by the ministry in conjunction with several medical institutions and the Lebanese Breast Cancer Foundation.

Every October for Breast Cancer Awareness Month, the ministry, along with local organizations, leads campaigns imploring women to get tested early and often.

Recalling doing her first 3D nipple tattoo, Antoun laughs, remembering how scared she was.

“I didn’t work for three days prior to the appointment to mentally prepare myself,” she says.

“When she came in, I actually started shaking a bit. It was the first time I had seen someone else’s breasts so intimately, but also breasts that were heavily scared and transformed after surgery.”

The first time was the most emotional for Antoun, who admits she struggled to stay professional as her client wept before the session started, and after the tattoos were finished. “I’m the kind of person who cries when I see a stranger cry, so it was really difficult. Her personal story about the diagnosis was one of the most upsetting I had heard,” Antoun says.

“For me, it’s not that expensive to do two a month for free. I freelance as a graphic designer and a photographer on the side.

“I do [the tattoos] for free because I think of what my mother would have gone through, and I would have wanted her to reclaim her body as she wanted.”

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