Breast reconstruction after mastectomy is a complex procedure that requires specialized care. Patients are advised to seek out a plastic surgeon who has experience with the unique needs of this procedure. When considering breast reconstruction after mastectomy, patients need to consider many factors, including their general health condition, skin type and color, overall body shape and size, age at which they would like to begin having children again (if applicable), as well as their personal preferences.
Nipple tattooing is an option that may be used in conjunction with breast reconstruction after mastectomy. Nipple tattooing can help create the illusion of nipples on reconstructed breasts that have been created using tissue expanders or implants. The nipple tattoos may also be used to fill in missing or damaged portions of the areola area surrounding each nipple before proceeding with reconstructive surgery.
Nipple tattooing is not recommended for all women who have undergone mastectomy surgery; however, those who do wish to have their nipples tattooed should discuss options with their surgeon before making any decisions regarding nipple tattooing.
In this exposition, we’ll also consider how long does it take to heal from nipple reconstruction and fake nipples after mastectomy.
Breast Reconstruction After Mastectomy Nipple Tattoo
Nipple reconstruction and nipple tattoos
If you’ve undergone a mastectomy, you may decide to also have breast reconstruction surgery. In most cases, when the breast is removed, the nipple and the darkened area around it—the areola—are removed as well.
Breast reconstruction creates new breasts in place of what was removed, and not everyone will elect to have the nipple reconstruction procedure that comes later. If you choose to, you have several options when it comes to reconstructing your nipple. Surgery to create a new nipple or nipples may be an option, but it’s not the only one you have. You can also decide to have nipple tattooing or use prosthetic nipples.
You have some time to decide how and if you want to reconstruct your nipple and areola. Nipple reconstruction or tattooing is typically done three to four months after reconstruction surgery, so that the breast has enough time to set in place and heal. If you decide to do both, similar healing time is also needed after nipple reconstruction before tattooing is done.
Learn more about what options are available when it comes to nipple and areola reconstruction and nipple tattoos, and factors to consider when weighing each option.
Nipple reconstruction surgery
If you choose this option, nipple reconstruction surgery is the final step in the breast reconstruction process.
Different techniques are available to obtain the necessary nipple tissue for this surgery.
- Skin flap reconstruction: Most of the time, a surgeon will use the skin of the reconstructed breast to form a nipple shape and stitch it closed.
- Skin graft reconstruction: Sometimes a surgeon may use a skin graft, where tissue from another part of your body, such as your inner thigh, is taken to form the nipple.
What to consider
Your surgeon’s goal is to be able to match this new nipple to your other one, or match both nipples to each other if you had both breasts reconstructed. The position, shape, size and projection—or how much they stick out—are all taken into consideration. You have a part in this conversation and process as well. You’ll share all of the decisions with your care team.
Nipple reconstruction surgery can make the area resemble a natural nipple, but it won’t necessarily give the nipple a natural color. If you want the nipple to have a color similar to a natural breast, or to have both nipples match, tattooing is an option after surgery. This is an additional procedure that can be done several months after the nipple is reconstructed.
How to prepare
Nipple reconstruction is usually an outpatient procedure. Because of this, you may not need to do a lot to prepare. Your care team may ask you to stop taking certain medications ahead of the procedure and to stop eating and drinking at a given time the previous night. Make sure to get your questions answered by your provider so you feel as comfortable as possible.
Recovery from nipple reconstruction surgery
Your care team will tell you how to care for yourself after nipple reconstruction surgery and provide specific instructions. It’s normal to have some swelling and bruising right after surgery.
- You’ll be given nipple protectors to cover the incisions for up to two weeks. You can shower, and your breast area can get a bit wet, but try to keep water from directly hitting it and possibly shifting the nipple protectors. You should avoid bathing in a tub or pool until your care team says that’s OK.
- If a bra is comfortable and fits with your nipple protectors, you can wear it. Or, you can wear a special post-surgical bra.
- A week or two after surgery, you’ll likely have a follow-up appointment in which your care team will check on your healing.
- You can resume most normal activities when you get home after surgery, but avoid doing anything that makes you sweat or any heavy lifting until after your follow-up appointment.
- Take pain medication as your care team prescribed it, and keep up with your fluids. Some pain medications can cause constipation, and drinking water can help avoid stomach issues.
Call your doctor right away if:
- Your pain worsens.
- The nipple protectors are irritating your skin and you see redness or discharge.
- You have a fever, nausea, vomiting, shortness of breath or leg pain.
Risks of nipple reconstruction surgery
Nipple reconstruction is typically an outpatient procedure with few risks.
But, with any reconstruction surgery, infection is always a risk, so make sure you understand your post-surgical instructions and call your doctor if you notice anything concerning in the area, like pus, a bad smell, or if you have chills or fever. One October 2013 study in the European Journal of Plastic Surgery points to nipple reconstruction being a high-risk procedure for people who have had radiation therapy.
Complications from nipple reconstruction surgery
Complications from nipple reconstruction surgery, though rare, may include:
- Flattening of the nipple
- Wound reopening
- Infection
- Injury to the tissue involved
3D nipple tattoos
No, nipple tattoos aren’t actually three-dimensional, but they look like they are. If you don’t want to, or are unable to, have another surgery, another option may be nipple tattoos. This can be performed by a plastic surgeon skilled in tattooing, or it can be done by another professional, even a licensed tattoo artist experienced in nipple tattoos. Using shades of pigment, these flat tattoos can be created to look three-dimensional.
What to consider
You have the option to have tattooing of the areola, the nipple or both. You can work with the professional doing the tattooing on how you want the pigmented color to look. Nipple tattoos can be a good option if you don’t want to have another surgery. Likewise, tattooing won’t leave scars, and has a much faster recovery period than that of reconstruction surgery. You can work with your tattoo artist on the specific look you want.
However, not every woman is a candidate for tattooing. Sometimes damage or thinning to the skin from radiation or surgery can change the way your tissue handles tattooing. It may also trigger inflammation and infection in some patients. All of these factors will be taken into consideration when you, your care team and tattoo expert decide on how the tattoo process could work for you.
How to prepare for a 3D nipple tattoo
Having a 3D nipple procedure is similar to having a tattoo anywhere else on your body, so there may be some discomfort during the procedure itself. You won’t usually need to do anything special to prepare for this procedure.
Risks of nipple tattoos
Infection at the site could happen, so make sure you’re following care instructions for the tattooed area at home, such as washing the area with soap and water and applying an antibacterial ointment.
Prosthetic nipples
The least invasive of nipple options is prosthetic nipples—it doesn’t require additional surgery or tattoo needles. Nipple prosthetics can give you the appearance of nipples, but they’re removable. Nipple prosthetics are made of silicone or other materials, so they look and feel close to the real thing. These prosthetics can be positioned and attached to the breast, and you can take them off whenever you’d like.
What to consider
Nipple prosthetics are a great option if you’re still trying to make a permanent decision about your nipples. You can use them and take them off whenever you want.
How to prepare for prosthetic nipples
Check with your insurance to see if they will cover nipple prosthetics. You may also need to do some research to find reputable companies that sell these prosthetics.
Risks of prosthetic nipples
Nipple prosthetics need to be cared for according to their directions, and you’ll need to inspect the site periodically to make sure your skin isn’t irritated by the prosthetic.
What to know about nipple tattoos after a mastectomy
Nipple-areola tattooing is a procedure in which a tattoo artist or plastic surgeon recreates the nipple and areola after breast reconstruction surgery.
Nipple reconstruction involves recreating a nipple using small pieces of skin from the reconstructed breast. A few months later, a surgeon can recreate the areola using tattoo ink.
Those who do not want to undergo nipple reconstruction can instead opt for a realistic image of a nipple by a tattoo artist.
Although some people feel that nipple reconstruction, whether from surgery or tattooing, is an important step to move forward, others do not. In the end, the choice is completely up to the individual.
This article discusses what a 3D nipple-areola tattoo is, the benefits and risks of getting one, and tips on aftercare and recovery.
What is a nipple tattoo?
Nipple-areola tattooing is a cosmetic procedure to help recreate an individual’s nipple.
Although nipple reconstruction is a popular choice for many, some people may decide to get permanent 3D nipple tattoos instead.
An experienced tattoo artist can create images of highly realistic-looking nipples. These tattoos will appear to be 3D but will be flat to the touch.
For those who have undergone a unilateral mastectomy, it is possible to match the color, shape, and texture of the existing nipple.
This procedure typically follows breast reconstruction surgery, but some individuals may use tattooing after nipple reconstruction surgery to add color or make their new nipple or nipples appear more realistic.
Nipple tattooing offers a less invasive alternative to surgery.
How to prepare for getting a 3D tattoo
The American Cancer Society (ACS) suggests waiting 3–4 monthsTrusted Source after breast reconstruction surgery to get nipple reconstruction or nipple tattoos. Some tattoo artists and studios may prefer that you wait 4-6 months after surgery before having nipple tattoos. This will give the new breast or breasts time to heal properly.
Having a visual consultation with the tattoo artist may be necessary in order for them to confirm that the skin has healed enough.
If a person has any known allergies, they may have to undergo a skin allergy test 24 hours before the procedure. This involves applying a small amount of pigment to the skin and seeing whether or not there is a reaction.
What to expect on the day of the procedure
On the day of the procedure, the person should arrive with clean skin. Also, the tattoo artist may ask them to avoid applying moisturizer on the night before or morning of the procedure.
They may also recommend that the person wears a loose-fitting shirt that opens in the front. Some facilities may provide gowns or robes for people to change into.
The tattoo artist may ask the person to sign a consent form or fill out a health questionnaire beforehand.
What to expect during the procedure
A person can expect the entire appointment to take 1–2 hours.
Before tattooing, the tattoo artist will discuss the colors, placement, and size with the person getting the tattoo.
If the person has one of their natural nipples, the artist will match the size and color of that. If the person has had both nipples removed, it may be beneficial to bring in a picture from before the surgery.
To determine the color, they will look at a palette of pigments, including varieties of pinks, browns, purples, tans, and beiges.
After mixing the pigments, the tattoo artist will apply a small amount to the skin so that the person can see how it looks in different lighting.
To help decide on the placement, the tattoo artist may use a silicone nipple. They will then draw markings to show the location, shape, and size of the new areola.
It can take approximately 30 minutes to tattoo one nipple.
Aftercare and recovery
Once the procedure is complete, the artist will apply a bandage to the tattoo. It usually takes 7–10 days for a nipple tattoo to heal. However, for skin that is thinner, healing can take up to a few weeks.
Once the tattoo is complete, the color is typically darker and more intense. The tattoo will lighten slightly as it heals. However, after 1–2 months, there should be no further color change.
Following the tattoo artist’s aftercare instructions will help the tattoo heal faster.
During recovery, a person should avoid chlorinated pools, bathtubs, hot tubs, and direct sun exposure. People can also apply antibacterial ointment to the area to prevent infection.
Does it hurt?
The reconstructed breast will not have the same sensations as before the mastectomy. As a result, the tattooing is not usually painful.
However, some people may experience mild discomfort or pain.
Benefits and risks
A person may opt to get a nipple tattoo as an alternative to undergoing surgery. This prevents the creation of new scars. In addition, the healing and recovery process is easier than that of nipple reconstruction.
Some people find that the results are better than if they had undergone nipple reconstruction surgery. This is because the tattoo can include fine details, coloring, and shading that may it look more realistic.
However, similar to getting a traditional tattoo, getting a nipple-areola tattoo carries a few risks, which can include:
- allergic reactions
- infections
- granuloma, which is a small area of inflammation
- keloids, which are raised scars
- dissatisfaction with the final result
Although the procedure is common and well-tolerated, some people may experience a delayed hypersensitivity reaction. This is otherwise known as a delayed allergic reaction.
A person in a 2019 case studyTrusted Source experienced a delayed reaction 7 weeks after the procedure despite having no reaction in the skin allergy test.
A person interested in 3D nipple tattooing should speak with a healthcare professional about any potential risks.
Where to get a nipple tattoo
A person can get a nipple tattoo from a member of staff at a plastic surgeon’s office or a qualified nipple tattoo artist.
Finding an artist who specializes in permanent areola and restorative tattooing is an important first step to getting a nipple-areola tattoo.
Although some individuals may have a tattoo artist in mind, others may ask a doctor, surgeon, or local cancer support groupTrusted Source for advice or referrals.
Once they have found a potential tattoo artist, the person may find it beneficial to ask to see a portfolio of the artist’s work. They can also ask about the sterilization practices the artist uses and whether or not they have a private room for tattooing.
Costs and insurance coverage
Although the cost of nipple tattooing varies, the average cost of one tattoo is around $350. A person can expect to pay $600–$800 for both nipples.
The Women’s Health and Cancer Rights Act (WHCRA) of 1998 requires group health plans and individual health insurance policies that offer mastectomy coverage to pay for all stages of reconstruction surgery. This includes any additional procedures a person may need to treat further complications.
Medicare often covers nipple-areola tattooing, while Medicaid coverage varies from state to state. Insurance may not cover nipple tattooing if an independent tattoo artist performs the procedure.
Who is unable to get 3D nipple tattoos?
A person may not be eligible to get nipple tattoos if they:
- have undergone radiation treatments that have damaged the skin
- have breast skin is too thin
- have lymphedema involving the chest
- have a history of infections in the area of the breast
Other options
If a person does not want to undergo nipple tattooing or is unable to do so, other noninvasive options are available. Other types of nipple reconstruction include the following.
Prosthetic nipples
People who cannot or do not want to get nipple reconstruction surgery or nipple tattoos may want to try prosthetic, or stick-on, nipples.
According to the ACSTrusted Source, prosthetic nipples are made of silicone and look and feel like real nipples. Some prosthetic nipples are self-sticking, while others come with a special skin adhesive.
Prosthetic nipples come in a variety of sizes, colors, and projections.
Temporary nipple tattoos
People who are apprehensive about getting a permanent tattoo can opt to use temporary nipple tattoos.
Temporary nipple tattoos are easy to apply and are removable with rubbing alcohol. Temporary nipple tattoos can last for 1–2 weeks, depending on the brand a person uses.
Nipple-areola tattooing is a procedure in which a medical specialist or experienced tattoo artist recreates the appearance of a person’s natural nipple.
Although flat to the touch, these tattoos appear 3D and realistic.
Many people opt to undergo some form of nipple reconstructive, but the choice itself is up to the individual.
How Long Does It Take To Heal From Nipple Reconstruction
Healing may take up to two weeks. The scars will be quite noticeable for between three and six months and will fade slowly over the following months and years.
Fake Nipples After Mastectomy
After your breast has healed from reconstruction or mastectomy, a plastic surgeon can reconstruct a new nipple and areola. The surgeon makes a star-shaped incision to form the new nipple and then adds a tattoo to shade in the new areola.