A breast cancer survivor may undergo breast reconstruction surgery and still not feel whole due to a lack of nipples and/or areolas on the front of the breast. In many cases, nipple and/or areola tattooing can help a woman feel more complete and natural after surgical reconstruction.
If this sounds like you, the Austin Plastic & Reconstructive Surgery medical tattooing team can help put the finishing touch on your reconstruction, whether you have implants, a living tissue reconstruction or a combination of the two. For many patients, areola tattooing can feel like the final piece of the puzzle after completing treatment for breast cancer.
What is an Areola Tattoo?
An areola tattoo is a way to construct a nipple and/or areola on a reconstructed breast for an entirely natural appearance. Many women are surprised by how much the lack of an areola can affect self-confidence, feelings of health and overall quality of life. Fortunately, patients can now restore this portion of the breast with a natural-looking and beautiful tattoo. Our certified medical tattooists, which include Africa Maldonado, MA and Kathleen Miller, MA, use similar techniques to those of traditional tattoo artists, but take additional care in blending and feathering the pigment to create a photo-realistic result.
Areola tattooing is not restricted to women who have had non-nipple-sparing mastectomies; even if you were able to preserve your nipples and areola during the breast reconstruction process, you may have surgical scars that can be visually corrected with a tattoo to create areola that are symmetrical and consistent in color.
How to know if Areola Tattooing is Right for You
Even though areola tattooing can help women feel more “whole” post-reconstruction, some do not pursue this procedure because they don’t believe it’s essential. However, the lack of an areola can be distressing for many women and can negatively impact feelings of femininity as well as physical intimacy with a partner.
Areola tattooing is an option for nearly every woman who has undergone breast reconstruction. Even patients who have not had their reconstruction performed by our plastic surgeons can come to our practice to get a beautiful, 3-dimensional looking result from our highly trained medical tattooing team. Our team will assess your case carefully to determine if this procedure is the right option for you given your goals.
"I am so happy I went to see Africa Maldonado for my nipple tattoos. I was a little nervous to go in, but Africa calmed my nerves immediately. She is so easy to communicate with. She is very professional, but it was like talking to a friend. She took time to talk to me about what I wanted in size and color. I don’t have an artistic eye, but she does. She added the colors to make a combination specifically to complement my skin tones. She tested the color until it was perfect. The result is amazing. The nipple tattoo is extremely realistic. I had to touch it because the shading is amazing. My eyes were convinced there was projection. This tattoo gave me so much confidence. I still look in the mirror and I am amazed a tattoo can look so real. If you need a nipple tattoo, make sure you ask for Africa. I promise you will be happy you did."
-Karen, 56-year-old breast cancer survivor
Is Areola Tattooing safe?
Yes. In the hands of a trained, experienced nipple tattoo provider, the procedure is considered very safe. Just as with any tattoo, there is a minor risk of infection. This is minimized through the use of sterile equipment and by following post-treatment care guidelines. It is critical to receive care from a licensed professional with direct nipple-tattooing experience to achieve the best results with the fewest risks.
Do Areola Tattoos hurt?
No. We use very fine needles to deposit ink beneath the skin. Prior to the tattooing portion of the visit, we apply a topical numbing medication to the skin to minimize its sensitivity. Patients find the process very tolerable and immensely rewarding as a final touch on their reconstructive journey.
Options in Areola Reconstruction & Tattooing
There are a variety of options in areola tattooing, depending on your specific situation and concerns:
This procedure is performed for women who have undergone breast reconstruction without surgical nipple reconstruction and would like to add a nipple and areola to their new breast(s). If both breasts require simulation, the medical tattooist will work with you to develop a blend of pigment you are satisfied with. It might be similar to the color of your areola before mastectomy, or could be a different tone, depending on your preferences. If just one breast was affected, the tattooist will mix a pigment that matches your native areola. Tattooing that simulates the protrusion of a nipple is called three-dimensional or “3D” areola tattooing.
Surgical Nipple Reconstruction with Areola Tattooing
If you had surgical nipple reconstruction, you may choose areola tattooing to complete your look. Dr. Fisher may perform nipple creation at the time of your breast reconstruction, using skin and tissue from the top of the mound of the newly constructed breast to create a protruding nipple. After you’ve healed from surgery, you can then have areola tattooing to bring pigment to the reconstructed nipple and surrounding skin.
Nipple-sparing mastectomy can be a good option for many women, but sometimes the areola can sustain scarring due to the cancer treatment and reconstruction process. In these cases, areola tattooing can be helpful in camouflaging the scars to produce rounder, more symmetrical areola. Color differences can also be corrected during this process.
Adjustment to Color or Size of the Areola
Whether your areola was altered after a nipple-sparing mastectomy or you are unhappy with an areola tattoo done elsewhere, our tattooing team can make adjustments to the color or size of your areola to make it look more natural and proportionate to the rest of the breast. Color adjustments can also be performed for women who have seen changes after breastfeeding or have a skin discoloration disorder like vitiligo.
Austin Plastic & Reconstructive Surgery
- Known for natural-looking aesthetic results in breast reconstruction and cosmetic surgery.
- Elected by peers for inclusion in Texas Monthly's Texas Super Doctors®: Rising Stars listing.
- Reconstructed over 6,000 patients, including more than 2,500 DIEP flap reconstructions.
- 4.9-star average rating over hundreds of reviews for reconstructive and cosmetic surgery.
What should a client look for in an Areola Tattoo artist?
The two primary characteristics that patients should look for when considering who will perform their areola tattoos include experience and artistic ability. Experience includes the training that the artist has completed that sets them apart as a medical tattoo artist, as well as the time they have spent performing areola tattoos in the clinical setting. We are very proud of our medical tattoo specialists and the care with which they treat our patients. The second characteristic, artistic ability, can be discerned by meeting with the artist and reviewing their previous clients' results. Our patients may do so in a comfortable, professional environment in which their questions can be answered thoughtfully and thoroughly.
Is Areola Tattooing permanent?
Areola tattoos are considered permanent. However, because the intent is to recreate the look of a natural nipple, this technique tends to deposit less concentrated pigment beneath the skin. As a result, some patients may notice fading over time. This typically occurs very slowly but is influenced by the patient's metabolism and lifestyle. Usually, patients do not notice fading for many years after their tattoo treatment. To maintain results, patients may be advised to avoid excessive contact with irritants such as glycolic acid, harsh cleansers, and chlorinated or saltwater. If the nipple tattoo fades, the patient may schedule a touch-up at any time.
When Should I Consider an Areola Tattoo After My Mastectomy?
You will need to wait until you are fully healed from your reconstructive surgery before pursuing areola tattooing. For most patients, this is about three to four months after surgery. If you want tattooing to camouflage a scar on the breast or areola, you may need to wait up to six months to avoid the risk of additional scarring. However, areola tattooing can be done at any point after the healing process is complete. Even if your reconstruction surgery occurred years ago, we encourage you to schedule a consultation at our office to find out if an areola tattoo post-mastectomy is the right choice for you.
Download Our Breast Reconstruction Post-Operative Care Guides
We've compiled detailed post-operative care instructions to best equip our breast reconstruction patients throughout their recovery process. To ensure the best and safest recovery, your plan encompasses appropriate prescriptions and clear directions towards maintaining your comfort to get you back to normal life and activity as soon as possible. Individual patients respond uniquely, and the type of procedure may differ, but these basic guidelines will help you along your journey.
About the Procedure
Areola tattooing is performed in our office by our experienced medical tattooists, Africa Maldonado, MA and Kathleen Miller, MA. If you lost sensation in the breast after your reconstruction, you will not likely feel anything during the tattooing process. However, topical numbing is available for those who do have some sensation and are concerned about their comfort level during the procedure. Your pigment will be carefully mixed to match the color you want, and an outline of the areola will be drawn on your breast. Special tattoo instruments will then be used to apply the pigment to the skin via fine needles. The entire process takes about two hours.
Care after Areola Tattooing
Areola tattooing aftercare is relatively simple. When your tattooing session is over, your artist will place non-stick pads over the areolas to protect them as they heal. You will be instructed to apply a thin layer of A&D ointment twice a day for the first two days. During this time, it’s also best to avoid strenuous exercise that could cause heavy sweating or friction on the breasts. Hot tubs, Jacuzzis and swimming pools should be avoided for a week, and you should not go into the ocean for at least two weeks.
The color of your areolas will likely be darker than you want at first; rest assured this is normal and the color will fade to a more natural look over the first four to six weeks. Flaking is also common in the first three to five days after your procedure and should not cause concern. If you have any significant pain, redness, swelling or oozing around the areola, you should contact our office right away to schedule an assessment as these symptoms could indicate an infection.
How long does it take for areola tattoos to heal?
It can take approximately two weeks for the skin to heal after nipple tattooing. A bandage may be worn for the first five days, after which patients may be advised to remove the bandage, wash the area with gentle soap and water, and dry using a patting motion. Nonscented, white lotion should be applied at least once a day. The skin may crust or scab. This should be left alone to fall off on its own.
Discovering Wholeness Once Again in Austin, TX
Some patients do require a second tattooing session to touch up the first treatment and adjust the color slightly. In most cases, the result will last for many years. The pigment from tattoos does tend to fade over time, so it is possible you will need another session years later to add a bit more color to the areola. Women who undergo areola tattooing are usually pleased with their results and find the process is the final step in reclaiming their health and their bodies. To learn more about this procedure, contact Austin Plastic & Reconstructive Surgery today at (512) 815-0123.