Paramedical tattoos softened her trauma, and now she eases others’ pain

Elsa Milani froze in front of her bathroom mirror, horrified at her reflection — her lip torn and dangling from her face. She was 12 when the dog attack happened, and that moment would lead to her life’s calling.

In the emergency room, she received 30 stitches, leaving her with scars and an asymmetrical lip line. Milani had been praised for her physical appearance as she was growing up, compounding the trauma of the disfigurement.

The dog attack happened during a six-year period when Milani was moving between foster homes. Now 34, she says she was in “survival mode” — even after graduating high school with honors at 18, moving into an apartment and obtaining a cosmetologist license.

Then, when she was in her 20s, a permanent makeup professional in Manhattan performed work on her scars and her lip.

“I felt beautiful again. I felt like a piece of me that was hastily taken was somehow given back to me,” she says. “It made me realize I wanted to help others feel that, too.”

Milani had discovered paramedical tattooing, a specialized art of camouflaging scars and skin irregularities. Unlike traditional tattoos, which are primarily used for artistic expression, paramedical tattooing serves both medical and cosmetic purposes, helping restore confidence after trauma or surgery.

Permanent makeup, a subset of this field, enhances features like brows or lips, but fades faster than traditional tattoos because the pigments aren’t as concentrated and require periodic touch-ups. The techniques differ too: Paramedical tattooing demands an understanding of color theory to blend pigments with natural skin tones and involves methods like microblading and scar camouflage.

With her own confidence restored, Milani uses her skills to help others in vulnerable situations.

Teresa Guzzardo, 63, has had multiple procedures — microbladed eyebrows, tattoo eyeliner, microneedling and lip tattooing. She says Milani is “a da Vinci at this.”

Over more than a decade, the New Jersey native has worked with hundreds of clients — from Chicago to New York City to Florida — many of whom are cancer survivors, burn victims, survivors of trafficking and domestic abuse and transgender individuals. Seeing family and friends affected by cancer inspired Milani to donate a free service every month to someone in need, ensuring that financial constraints don’t stop them from getting treatment.

“Everything I do is kind of like a labor of love,” Milani says. “It is connected to me somehow because a loved one went through it or I went through it.”

A first-generation American, she moved to Chicago in 2014 to care for her grandfather, renowned London-born artist Tony Hepburn, when he entered hospice home care. His wife, Milani’s grandmother, had died years earlier, and Milani says she didn’t believe that anyone should die alone, so she stayed. Unexpectedly, she fell in love with Chicago and is based in Lake View now.

Many clients are cancer survivors who have received treatment from Northwestern Medical Hospital or from Sharsheret, a national organization that offers emotional and financial support to 275,000 women battling cancer each year.

“They no longer have to compromise quality-of-life services because they can’t afford it because they’ve used so much of their funds for cancer treatment,” says Elana Silber, Sharsheret CEO.

Ethel Brown, 30, a breast cancer survivor who lives in South Deering, received brow correction and areola reconstruction services from Milani through Sharsheret.

She says she was able to regain a piece of herself that she believed was long gone. Milani, she says, “donates herself and her time to helping cancer survivors feel back to themselves or give them back what they feel they’ve lost or are missing.”

Sharsheret works with paramedical tattoo artists nationwide, and Milani is the organization’s sole Midwest paramedical tattooer. Silber says that Milani and others’ work is not purely cosmetic.

“These [paramedical tattoo artists] are not just people fluffing color onto faces or onto breasts,” she says. “They’re doing real art, and it makes clients feel like themselves again, like the way they looked before they had treatment.”

In addition to cancer survivors, Milani’s clients include people who face other challenges related to their appearance. Joseph Tillman, 49, a military veteran who lives in Lake View, sought Milani’s expertise in scalp micropigmentation, a treatment that restores the appearance of hair density for people with thinning hair or baldness.

For 20 years, he sprayed hair fibers on his scalp daily, leaving his bathroom covered in dark residue. When he also needed dental reconstruction, compounding his self-consciousness, he wanted a better solution for his hair, he says.

Then he met Milani.

“She’s taken away that self-consciousness, almost to the degree of 100%,” Tillman says.

When Evangelina Geldis, 55, had a non-cancerous tumor, the medications and stress caused her to lose hair. She also had received a botched eyebrow service, which left her brows a greenish color. Geldis felt so uncomfortable about her appearance that after 33 years with her company, she skipped its annual photoshoot.

With scalp micropigmentation and brow correction services from Milani, Geldis says she finally felt like herself again.

“That was life-changing for me,” she says.

Milani herself has 72 tattoos — including a phoenix that she says reminds her of her purpose and strength. Her artistic roots run deep. As a child, she says, she was inspired by her grandmother, a painter, and her grandfather, Hepburn.

Her grandfather lived in a way that Milani says she carries forward today.

“You have to like what you do,” she says. “I appreciated that about my grandfather.”

Milani’s work is transformative, says breast-cancer survivor Cassandra Everett, 42, a former client and longtime friend.

“It is a really big thing for someone to gift you in life: to be able to walk out the door and feel like you are regular again.”