CNN reported last year on a study published in Annals of Surgery that showed that the rate of double (a.k.a. bilateral) mastectomies tripled in the 10 years between 2002 and 2012. Not everyone opts to have their breasts reconstructed after a mastectomy — it’s a matter of individual preference — but many do. And, like Irena, they’re often left without nipples. That absence can take people who have already been through so much on yet another emotional rollercoaster.

The good news? For those who want the appearance of nipples (again, it’s a personal choice), there are options. There’s surgical reconstruction. There are nipple prosthetics. And then there are 3D nipple and areola tattoos, which can be done by a medical professional or a tattoo artist.

Irena went with the latter and underwent the procedure in 2015 at New Jersey’s Beau Institute, a permanent cosmetic institute that specializes in advanced corrective cosmetic techniques.

Beau Institute offers all sorts of permanent cosmetics, but nipple and areola tattoos are something the founder, Rose Marie Beauchemin, feels particularly passionate about. This October 24, Beau Institute is holding its seventh annual “Day of Hope,” during which it will provide those who have undergone mastectomies with complimentary 3D nipple and areola tattoos. Typically, Beau Institute charges $350 per areola for tattoos. While some insurance plans cover nipple and areola tattoos, in particular those done in a medical setting, the extent of the coverage varies from plan to plan.

“I started the Beau Day of Hope when I realized how many women are out there that have never followed through with the tattoo after receiving a mastectomy,” Beauchemin tells Allure. “The reason was, they were under the impression their completion required another surgery for the nipple, which would be a nipple graft.”

Many of those who have had mastectomies and reconstructive surgery have also been through chemotherapy and radiation, Beauchemin says. They aren’t willing to undergo another surgery, even if they miss having nipples — Beauchemin says some Beau Institute patients have “shared that their husbands have not seen them undressed for five to seven years, or they haven’t looked at themselves in a mirror for several years” — and they don’t know that 3D tattoos are an option.