Breast Reconstruction Areola Repigmentation/Tattooing

Reconstruction of the breast can be a very emotionally and physically rewarding procedure.  Not all women desire reconstruction, and it is not a requirement.  But many women, perhaps most, find it to be very beneficial in returning to a more normal life after breast cancer.

The final step of breast reconstruction is tattooing the areola.

What is Areola Repigmentation? Nipple areola tattooing typically takes less than an hour and can be performed in-office. If you have undergone unilateral breast reconstruction, we can mix pigments so that the tattoo closely matches your existing nipple areola color. This process is divided up into two appointments. A 6-8 week appointment is required after the first appointment to make sure that the color is even after it is completely healed.  Depending on scaring and different skin types two appointments are required.  If you have undergone bilateral breast reconstruction, we can create the appropriate natural color based on your pre-mastectomy photos, or we can mix pigments to create a color that nicely complements your skin tone. The choice of nipple areola color can be slightly darker or lighter depending on an individual woman’s preference. These procedures help improve the appearance and self-esteem of women who have undergone breast surgery. Areola Repigmentation techniques can “create” an areola after breast reconstruction, minimize the appearance of scars, or restore an areola to a more natural looking color and shape.

How Areola Restoration Helps People after Breast Surgery: The areola is part of the human breast in both women and men. It is a circular area of skin around the nipple that is often darker and thicker than the surrounding skin. The areola plays a key role in the aesthetic look of a breast. Since a woman’s self-image can depend on the appearance of her breasts, a missing areola can be psychologically devastating. A woman can survive breast cancer after undergoing a mastectomy, and she can regain her figure with a breast reconstruction. However, she may not feel “complete” without an areola. A woman can become emotionally distressed from a scarred areola as well.  Areola tattooing provides the “finishing touch” after breast surgery. Patients feel the tattooing process helps them during the last part of their recovery to look complete and feel “whole” and “normal” again.

Areola Tattooing Techniques

Full Areola-Nipple:

This procedure is for patients who have had breast reconstruction after a mastectomy or lumpectomy. Cosmetic tattooing techniques and color pigments are used to create the appearance of an areola. For a unilateral mastectomy patient, this process helps the reconstructed breast to match the natural breast. For patients with bilateral breast reconstruction, both areolas are recreated. Areola complex simulation can be achieved with or without a nipple button created by the surgeon.

Areola Scar Camouflage:

Many breast operations require one or more incisions at or around the edge of the areola which may produce scarring. The most common peri-areolar scars are from breast augmentation or reduction surgeries. A scar’s appearance can be softened, blended, or reduced by tattooing the areola scar using corrective pigment camouflage techniques.

Areola Size or Color Adjustment:

The color of an areola can be darkened, balanced, or enhanced with tattooing. The process helps women who have discolored or lightened areolas after breastfeeding or patients who have had areola graft surgery. Patients with skin discoloration disorders (e.g. Vitiligo) can also benefit from areola tattooing. Also, individuals who have not had breast surgery but are self-conscious about their areola color or size (too light or too small) may choose this procedure to adjust their appearance.

Post-Operative Care

For the first 5-7 days after your appointment, you should change your dressings twice daily or more frequently if needed. Make sure your hands are completely clean and gently apply the post-care ointment with clean hands. At each dressing change, the ointment is reapplied. We recommend that you apply a liberal amount of ointment and use the non-adherent gauze. The tattoo will ooze a combination of blood and ink for approximately a day following the tattooing, but this is normal. As the bleeding dissipates and the ink incorporates, the true color of the nipple areola tattoo will become more apparent. Many patients are surprised by how dark the tattoo may appear the day after treatment, but it is important to remember that this color will fade.

The following must be avoided during all 7 days post-micro blading procedure:

Increased sweating

Practicing sports


Hot sauna, hot bath, or Jacuzzi

Sun tanning or salon tanning

Picking, peeling, or scratching the tattoo in order to avoid scarring or removal of the pigment

Please wash carefully without getting water on the treated area. During the shower, keep the away from the showerhead or take a bath.

Itching and flaking may appear during the first seven days post-micro blading procedure.

During recovery, it is advised that you keep the nipple areola tattoo moist with ointment. In order to minimize the risk of agitating the tattoo, some women choose to avoid wearing bras or shirts while at home in the early period after tattooing. Over the course of several weeks, the tattoo will heal completely and the true color will be revealed. If the color is not ideal, an additional nipple areola tattooing session can be used to achieve the color you desire.

All cosmetic tattooing post breast reconstruction is performed by Cassandra Walker. Cassandra has been part of our breast reconstruction team for the last several years. She is very gifted and skilled in the art of cosmetic tattoo. If you are interested in scheduling a consultation please call us at 801-322-1188. Thank you.


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