Rise Skin Studio
Your Questions, Answered.
Krissy Dykhouse is a registered nurse and a certified paramedical tattoo artist. These are the questions women actually ask her, answered on camera, with the full transcript under each one.
Is this for me?
Do I really need this? Is it a big deal?
It's the most personal decision you'll ever make, and it isn't anyone else's to make for you. But you deserve to feel whole again. Cancer took something that made you feel like yourself. This is how you take it back.
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I would tell them that it's just the most personal decision that they could ever make. And it's not for anyone else to decide on. And that's the beautiful part of it. A lot of people will say, do I really need this? Is it a big deal?
Yes. You deserve to feel whole again. You weren't robbed of something. Cancer didn't steal your nipples and a part of you that made you feel beautiful and feminine. And sure, it has to be for you and for nobody else, which is a very intimate decision.
I had my mastectomy years ago. Am I too late?
No. There's a minimum: six months after your last surgery, with your surgeon's okay. But there's no maximum. Krissy has worked with women ten years out and forty years out. Some are getting it done for the first time. It's never too late.
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Minimum: six months. And we need the okay from your plastic surgeon. Beyond that, there is no maximum.
I've worked with patients ten years out. Forty years out. Some have never had it done before. Some come back for color boosting after a decade. It's never too late.
Isn't this just cosmetic?
No. Calling it cosmetic is exactly what lets insurers refuse to pay for it. This is the last stage of reconstruction, restoring something cancer took, so you recognize yourself again. Krissy is a nurse before she's an artist, and she'll argue this one every time.
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One of the most common misconceptions about my work is that it's cosmetic. And it's not.
Areola tattooing is so much more than a cosmetic procedure. It is truly creating healing and quality of life and giving these women their power back, that they thought was maybe gone forever, was stolen from cancer and all of their treatments.
Can I still get tattooed if I went flat?
Yes. Going flat doesn't close this door. It opens a different one. Floral and artistic work over the scar line, or a decorative nipple if that's what you want. Krissy trained in artistic tattooing specifically so women who don't reconstruct still have a choice.
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I want to be able to offer patients non-traditional nipple tattooing. If they want floral or some other design over that skin. If you look it up online, it's beautiful.
I don't want to call it a distraction because it's not. It enhances that area without having anything there. We could do nipples too. We could try a nipple and see if they like that, and if not, then we can add to that, or cover it with floral and other things that they might want.
Will it actually look real?
That's the whole craft. A 3D areola tattoo uses color, shading, and tiny detail dots to read as dimensional on a flat surface. Krissy will show you her portfolio at the consult. It's the fastest way to answer this, and she'd rather you saw it than took her word for it.
Can I see before and after photos?
Yes. Krissy keeps a full portfolio and shares it at consults. For obvious reasons this work isn't all posted publicly. Ask and she'll walk you through it privately.
Why did no one tell me this existed?
You're not alone in asking, and it isn't your fault. This step often doesn't get mentioned during treatment, when there's a great deal else to get through. Many women find it years later, by accident. That's part of why Krissy talks about it as openly as she does.
Is there an age limit?
No. Many of Krissy's clients are in their sixties, seventies, and eighties, and a good number are getting their first tattoo ever.
Can I get this if I never had cancer?
Yes. Breast lift, reduction, or augmentation can all change or lose the areola, and the same restoration work applies. Bring your history to the consult.
What about after top surgery?
Areola restoration after gender-affirming top surgery uses the same technique. Get in touch and Krissy will talk through what you're hoping for.
What actually happens
Does it hurt?
For most women, no. The nerves in that area were cut during surgery, so there isn't much feeling left. If you do feel something, Krissy starts with a test spot and can use a topical numbing agent from there. Many of her clients are getting their first tattoo ever, in their sixties, seventies, eighties.
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A lot of them are women ages sixty-something to eighty-something, and they've never had a tattoo before. Or they're still kind of in the thought process of it being a taboo thing: bikers and people in jail are the only ones with tattoos. Which is hilarious, because it's not true, but that's the mindset they've been in. So it's like, this is my first tattoo. It is nerve-wracking for them.
I always reassure them that most of the time, all those nerves have been cut through. There's not a lot of feeling there, and they know that. So I just reassure them that you likely won't feel a lot. And if you do, for some reason, I'll do a little test spot. If you do feel too much, then I can use a numbing agent on the surface of the skin, and that eliminates 95% of pain.
How long after surgery do I have to wait?
At least six months after your last surgery, and you need your plastic surgeon's okay first, no matter how long it's been. They know what happened in there and what complications came up. That clearance is step one, every time.
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I always tell them they have to wait at least six months post last surgery. They have to get an okay from their plastic surgeon. That's the main thing.
I don't care how long it's been. If you call me and it's been six months, I'm still going to have you call your plastic surgeon and say, they need to okay it. They know exactly what happened from start to finish with those surgeries and what complications did arise, and if this patient is ready for this. That's step number one.
What actually happens, start to finish?
A consult first, in person or by Zoom. Then a first appointment of about two hours. Most of that is paperwork, mapping, and choosing color together. The tattooing itself is 20 to 30 minutes. A second session comes six to eight weeks later and is included in your fee. If you need a third, Krissy doesn't charge for it.
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We set up a phone call for a consult. You'll come to my studio in person, or Zoom. I have done out-of-state patients, we can do a Zoom consult if they don't want to come multiple times.
They come then for their first appointment. That takes about two hours. I always set aside a lot of time for paperwork;there's a lot of paperwork involved. And then we spend quite a bit of time mapping them out, picking colors together, and just kind of talking through the process. The tattooing itself doesn't take too terribly long, probably about 20 minutes to half an hour, depending on the condition of the skin and scarring.
I always include a second appointment in the initial fee. That is done six to eight weeks after that. And then I always tell them after that, if there's a third appointment needed, please get ahold of me. I'm not going to charge you for it. I just want to make sure you're happy with your results.
How do we decide what they'll look like?
However you want. Bring a photo from before surgery and Krissy will match it: size, color, all of it. If you don't have one, or you'd rather not, this becomes your choice to make fresh. She keeps pigment swatches and a full portfolio, and you pick together.
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I can show them pictures. I've had several bring in pictures of their own, either the physicians took a picture prior to surgery, or it's a picture that they just had at home, which is good for them. And they're like, I really liked my nipples before I had the surgery, this was the color they were, this is the size. And so I can absolutely mimic anything that they want.
If they have no idea, then I tell them: this is your gift to yourself. You get to choose whatever you want. If you want bigger nipples, small nipples, light, dark, whatever color. I have tons of pigment swatches and pictures in my portfolio, and we just kind of talk about it.
Another little fun detail is the little dots on the nipple that make it look really realistic. Some people don't want those;I'd say a majority do. I've also had people put little names into their nipples, for someone that they love, a significant other. So I can just kind of hide that in the wrinkles and the details. It can be kind of anything you want it to be.
How much lighter will it look after it heals?
Noticeably lighter, and that's expected. Fresh pigment always looks darker and more saturated than the healed result. This is the single most common reason women panic in the first week. It settles. The second session is where the final depth of color gets built.
What's normal while it heals, and when should I worry?
Redness, tenderness, and some flaking in the first days are normal, and the color will look off before it looks right. Call Krissy if you see spreading redness, increasing pain after the first couple of days, drainage, or a fever. She's a nurse and she'd rather hear from you early.
What are the risks?
As with any tattoo: infection, pigment migration, or a reaction to pigment, all uncommon. Reconstructed and radiated skin heals differently, which is why the surgeon's clearance and the six-month wait exist. Krissy will go through your specific risks at the consult.
Who shouldn't get this yet?
Anyone still within six months of surgery, anyone whose surgeon hasn't cleared them, anyone with active infection or unhealed incisions, and anyone in active treatment where their care team wants to wait. If Krissy thinks you should wait, she'll say so.
Can you tattoo on radiated skin?
Usually yes, with adjustments. Radiated tissue holds pigment differently and often needs more time between sessions and sometimes an extra one. Krissy will tell you honestly at the consult what to expect from your skin rather than promise a result it can't hold.
Can the needle hit my implant?
No. Areola tattooing works in the upper layers of the skin, nowhere near the depth of an implant. It's one of the most common worries women bring in and one of the easiest to put down.
Can you match my other side if only one breast was removed?
Yes, and this is exactly the symmetry work the federal law is written around. Krissy matches color, size, and shape to your remaining side.
Do I need nipple reconstruction surgery first?
No. A 3D tattoo creates the look of dimension on a flat surface using color, shading, and detail, no surgery required. Some women have surgical reconstruction first and tattoo over it. Many skip straight to the tattoo.
Will this affect my mammograms or an MRI?
It shouldn't. Tell your imaging technologist you have a cosmetic tattoo in the area before any scan, the same way you'd mention any other tattoo, and let your care team make the call for your situation.
Can you fix an areola tattoo that didn't turn out well?
Often, yes. Krissy has corrected work done by others, including by surgeons. Bring photos to your consult and she'll tell you honestly what can be improved and what can't.
Insurance and cost
Does insurance have to cover this?
Yes. The Women's Health and Cancer Rights Act of 1998 is a federal law. If your plan paid for your mastectomy, it has to pay for reconstruction and for anything that restores symmetry. Getting them to honor it is the fight, and Krissy has spent four years learning how to win it. One thing to know: Medicare, Medicaid, and some church and government plans run under different rules, so check which one you have before you call.
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The Women's Health and Cancer Rights Act of 1998 is a federal law that requires any insurance providers who pay for a mastectomy, they have to also pay for reconstruction, anything to create symmetry. If they have one side done and not the other, then insurance is required to pay for making that side look like the other side, just to create symmetry and balance after surgery.
It's been four years and quite a battle. I didn't know it would be another one of my life's missions to get insurance to cover it. In my lifetime, I will get this process smoothed over, where a patient doesn't even have to battle through it. If you have a mastectomy, then you get to pick someone who's specialized in this service, and you get to go to them. And it's supposed to be covered under the federal law.
What do I say when I call my insurance?
Call and say: I want to get this done, I was referred by my plastic surgeon, what do you need from me to have it paid for or reimbursed? They will likely tell you it isn't covered. That's the start of the conversation, not the end of it. Krissy has spent about 20 hours on the phone for a single client, and she'll walk you through it.
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I always tell them from the beginning to call their insurance company, act like they know exactly what they're talking about. And I kind of talk them through a little bit of a script.
Backing up to that first phone call, I have them call and just say, hey, I want to get this done. I was referred by my plastic surgeon. What do you need for me to get paid for this, or reimbursed for this? They'll always say things like it's not covered, and all of this. So then it starts the process of probably 20 hours on the phone for each patient, to just talk to different people to try to get them to give me the required information that they need and the required documents.
What if I just pay for it myself?
You can, and plenty of women do. They're exhausted and they just want it done. Krissy understands it and she'd still rather you didn't. Every woman who pays out of pocket lets the insurer off the hook for a law they're supposed to follow. She would rather take their money than yours.
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I have a lot of patients that just say, you know what, I don't want to deal with it. I'll just pay for it. Well, that just lets insurance off the hook. And then they don't have to comply by the federal law that is in place.
I'm sad for the patients who are just tired. They don't want to fight. They've gone through so much, and they just want to pay for it. I hate that. I don't want to take their money. I want to take money from the insurance companies that they've paid thousands, if not hundreds of thousands of dollars into their premiums.
Will it fade?
Yes, like any tattoo. How fast depends on your skin and even what you wear. That's normal and it's planned for. Krissy stays your resource for as long as you need her. If they fade quickly you come back and she goes over them again, and you can pursue reimbursement for touch-ups too.
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They do fade. It varies based on the person: the skin, how oily their skin is, do they wear super tight clothing or not. There's different variables and factors.
But I always tell them when they leave: I'm here forever as a resource. So give me a call. If they fade really fast, then we'll just go back over them again. If we need to try to get reimbursement again and do it in a couple of years, then we can do that. But just don't feel like you have to go home with this one round and be done. I'm here to help you with that long-term goal of having them look really nice forever. But yes, it will take retouches and work over time just to keep them looking nice.
Do you bill my insurance directly?
No. Rise Skin Studio is an independent studio. What Krissy provides is an itemized receipt and the documentation you need to submit for out-of-network reimbursement, plus the coaching to actually get it through.
What documents should I ask my surgeon for?
Your diagnosis code and the relevant procedure codes from your surgeon's office. Those are the first things your insurer will ask for, and having them before you call saves a round of phone tag.
What if there's no one in-network near me?
Ask your plan about a gap exception. When there's no in-network provider who performs a covered service within a reasonable distance, plans can sometimes cover an out-of-network specialist at in-network rates. In a state with almost no paramedical specialists, that's a real argument.
I'm on Medicare. Is it different?
Yes. The 1998 federal law applies to group and individual health plans, not to Medicare or Medicaid. Those follow their own coverage rules. Medicare does cover breast reconstruction after a mastectomy for breast cancer. Call and ask specifically what your plan covers for nipple and areola reconstruction, and bring what you learn to your consult.
My claim was denied. Is that the end of it?
Not necessarily. A first denial is common and plans have an appeals process. Krissy has been through this many times and keeps documentation from previous claims. Tell her what they said and she'll help you work out the next step.
Do you offer payment plans?
Ask. Krissy would rather find a way than have cost be the reason someone doesn't finish this.
Do touch-ups cost extra?
Your second session is included in the initial fee. If a third is needed to get it right, Krissy doesn't charge for that either. Retouches years later are a separate visit, and reimbursement can be pursued for those too.
Why Rise Skin Studio
Why not just go to a tattoo shop?
You could, and there are excellent artists there. Krissy will say so herself. The difference is specialty and setting. She works on reconstructed skin all day, and she built a private studio that feels like neither a hospital nor a tattoo shop, because most of her clients have never been comfortable in either.
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You could go to a tattoo shop. I have a lot of friends in the tattoo industry. There's nothing against them. We all just have specialties, right? If you were to go into a tattoo shop, you would look at their portfolio ahead of time and know what kind of style they do. So I would just say I offer that as my specialty. I've dedicated my trade to that, and most of my time to perfecting that.
The other piece is just the feeling of the space that I wanted to create. I didn't want it to feel like a hospital. And I didn't want it to feel like a tattoo shop. A lot of these older women especially have never set foot in a tattoo shop. And so I want them to feel comfortable.
One of my eighty-year-old patients said she had hers done in the basement of a tattoo shop. It was this little private room, but you walk through the tattoo shop, and that's the only space they could offer that was private. In this kind of dungeony basement. They've been through too much to not have an experience in the space as well.
You're a nurse. Why does that matter?
Because South Dakota has no state tattoo license, which means anyone can call themselves qualified. Krissy is a registered nurse with 15 years in hospitals and a certified paramedical tattoo artist trained in Texas. She's read your chart and she's held the needle. Not many people can say both.
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I get this a lot: you don't look like a typical tattoo artist.
I'm a registered nurse. I worked in hospitals for 15 years. I'm also a certified paramedical and cosmetic tattoo artist. Both things can coincide. I can show up in scrubs and be a safe place. And I can show up in sweatpants and a beanie and be myself. Both things are who I am.
I went to Texas to train with a paramedical tattoo instructor. We did a course and then a live model day, so I was able to tattoo with her to get the full experience, what that looks like for the patient from the start to the end, and meeting in the plastic surgeon's office and performing that procedure.
How many of these have you done?
Close to a hundred over four years. Enough that Krissy has been asked to correct work done by others, and enough that she's stopped being able to remember every single one, which she'll tell you she's a little sad about.
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I should figure that out. Gotta be close to a hundred over four years, would be my guess. Somewhere in that range.
I remember when I started to kind of lose track. Like, I knew every detail of every patient, and they weren't as frequent, and that was cool. And then when I started to lose that because there were more of them, it made me sad. But at the same time, I want to help as many people as possible. So it's just connect with them as best I can when they're here.
What do women say afterward?
That it wasn't about the tattoo. Women tell Krissy the difference shows up later, passing a mirror and seeing a whole person instead of a reminder. One client's husband waited in the car at her follow-up. Krissy watched them hug in the parking lot.
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It takes a little bit for them to really process it. They'll look and they're always excited. But I just feel like it's down the road when I talk to them and they've had it completed for a while. It's just like, wow, I didn't know the difference that it really would make. When I'm looking in the mirror, and it's not even like they're looking at their nipple. It's just seeing myself as a whole person in the mirror. Had no idea that that would be such an incredible experience.
I'll never forget. One of my patients left and I saw her give her husband a big hug out in the parking lot. He had come to the previous appointment. He was sitting here in the first appointment and he was wonderful and just adored her. You could tell. And they had just been through a lot. He was waiting in the car at her follow-up, and she went out there and they hugged. It's just healing for everyone involved.
Why do you do this work?
Krissy's dad had colon and liver cancer. There was never much of a community around that. The breast cancer community gave her one. As she puts it, the women she works with heal her every time they come in, and she doesn't think they realize it.
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My dad had colon and liver cancer. There's not a real tight community for that, but the breast cancer community has filled lots of spaces in my heart that I was longing for, just some sort of support, and people cheering each other on and being there for each other through all the hard times and treatment.
I mean, my patients help heal me every time they come in. And I don't think they realize that, but it really is. That part of it is a dream.
I'm a surgeon or nurse navigator. Can I refer a patient?
Yes, and Krissy would rather you did. Send them for a conversation, not a booking. She's a nurse, and a lot of women just want to talk to someone outside the clinical space. If they aren't ready, she won't chase them.
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No pressure for tattooing. Honestly, all things aside, in the last four years I've learned so many things. I always say that: if we consult or we have a conversation, I will never call you again unless you want me to, or you call me back if you're ready to get tattooed.
But if you just want someone to talk to outside of it. A lot of people don't have medical people in their families, and a lot of people are just overwhelmed and they want someone to talk to. It's kind of like going to therapy, just talking to a third person outside of your world. Sometimes it's just very nice to have that resource.
Is the studio inspected? Do you use single-use needles?
Single-use needles, every time, and the studio meets South Dakota Department of Health facility standards for sterilization and sanitation. Worth knowing: South Dakota has no statewide tattoo license, so ask any artist you're considering about their training, sterilization, and bloodborne pathogen certification. Krissy would rather you asked.
Going flat and artistic work
What kinds of designs can go over a flat closure?
Floral and artistic work is the most common request. Krissy completed a non-traditional apprenticeship specifically so she could offer this. It isn't a distraction from the scar. It's a way to make that area yours again.
Can I do a decorative nipple on a flat chest?
Yes, and you can try one and change your mind. If it isn't right for you, it can be added to or covered with a design.
Can I bring my own design?
Bring whatever you've been saving. Krissy works largely freehand over scar tissue rather than from a rigid stencil, so there's room to adapt a design to how your skin actually sits.
Do you do regular tattoos?
Some. Krissy takes smaller artistic pieces around her client schedule. Restoration work always comes first.
Can you tattoo over a C-section or tummy tuck scar?
Yes. Scar camouflage is one of the services Krissy offers alongside areola restoration. Bring it to your consult and she'll tell you honestly what she can do with your scar and what she can't.
Booking and visiting
How do I reach you?
Website, email, or text, whichever is easiest. Krissy is fine with a text, and says so plainly: people text now, and a short message saying you have surgery coming up and want to talk is enough to start.
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Patients, or whoever is interested in the work that I'm doing and wants to get a hold of me, can go to my website at riseskinstudio.com. They can contact me there. They can also email me, and my cell phone number is on the bottom of the webpage if they feel more comfortable texting me or giving me a call.
In 2026 I feel like a lot of people like to text, and I'm okay with that. Some people think it's not professional, but I think we kind of have to adapt as the world changes. If they just want to shoot me a text and say, hey, I'm having surgery in August and I don't know about tattoos but I want to talk to someone. That makes it easy.
Where are you, and how far do clients travel?
Rise Skin Studio is at 310 S. Splitrock Blvd. in Brandon, South Dakota, inside Glo House Suites, about fifteen minutes from Sioux Falls. Clients come from across South Dakota, Minnesota, Iowa, and North Dakota.
How do I book?
Start with the contact form, or call or text 605-530-0057. The first step is a conversation, not an appointment.
Is the consultation free?
The first conversation costs you nothing. Krissy has said plainly that she's happy to talk to someone who just wants to talk. There's no obligation to book anything.
How soon can I get in?
It depends on the season and where you are in your recovery. Reach out and Krissy will tell you what's realistic, and if you need to wait longer for medical reasons, she'll tell you that too.
Can we do the consult remotely?
Yes. Krissy does Zoom consults for out-of-state clients so you aren't driving out more than once.
Can I bring someone with me?
Of course. Partners, daughters, friends. People sit in on first appointments all the time. Come with whoever makes this easier.
What should I wear?
Something loose and easy to change out of. Avoid anything tight over the area for the first stretch afterward.
Will I be sitting or lying down when you mark the design?
Upright. Marking is done seated or standing so the design sits where it should when you're on your feet, not just when you're on the table. It's a small thing that makes a large difference in the result.
What can't I do while it heals?
No swimming, hot tubs, or soaking, no direct sun on the area, and nothing tight over it. You'll get written aftercare at your appointment, and Krissy is reachable if anything looks off.
My surgeon retired and I don't have my records. Can I still do this?
Usually. You'll still need clearance from a physician, but it doesn't have to be the surgeon who operated on you. Get in touch and Krissy will help you work out who can sign off.
I'm nervous. I've never had a tattoo.
Most of Krissy's clients haven't either. The studio was built for exactly that: private, quiet, and nothing like a tattoo shop. You can come see it before you commit to anything.
Still have a question?
Ask it. There's no appointment on the other end of this and no pressure to book one, just a nurse who has answered it before and will tell you the truth.
Send Krissy a messageor call or text 605-530-0057
Like the sun, we always rise again.
The information on this page is educational and is not medical, legal, or insurance advice. It is not a substitute for evaluation by your own surgeon or care team, and coverage depends on the terms of your specific plan. Federal coverage requirements referenced here come from the Women's Health and Cancer Rights Act of 1998. Always confirm details with your plan and your providers.