Areola Pigmentation After Breast Reconstruction

Each month we provide 2 free Areola Repigmentation services for breast cancer survivors.

While there are many options in breast reconstruction (including using breast implants or using a woman’s own tissue to reconstruct a breast), all methods end with the reconstruction of the nipple and the areola (pigmented skin around the nipple). Areola pigmentation, sometimes called “nipple tattooing,” is the final step to the breast reconstruction process.

Our ultimate desire is that you selected a method of breast reconstruction in which you feel comfortable with the new breast(s). Your reconstruction is completed by adding the circular darker skin around the nipple, called the areola. There are various techniques to provide unique skin colours for a patient in an effort to recreate an areola. These usually include either harvesting a skin graft from the patient or a pigmentation applied around the nipple, much like a tattoo.

Areola pigmentation is completed no sooner than three months after nipple reconstruction to allow the latest incisions to heal well.

No matter the timing of your visit to Wellington Permanent Makeup, Dasha will help you select a shade from a large colour spectrum we have at the studio. Regardless, you may select whatever colour you prefer — allowing this final step to becoming an elective, customizable procedure for you!

How Does Nipple Tattooing Work?

Areola pigmentation is done under local anaesthesia. We use medical-grade pigments and medical-quality tattooing instruments.

The pigment is permanently placed using “tattooing” techniques. As with any tattoo, the pigments will tend to fade with time and acquiring the precise shade may require more than one pigmentation (tattoo) procedure.

How Areola Repigmentation 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 breast reconstruction. However, she may not feel “complete” without an areola. A woman can become emotionally distressed from a scarred areola as well. A man’s self-esteem can also be lowered by the appearance of his chest and breasts. 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.

What Causes Areola Scars?

Surgical procedures on the breast can create a scar if they require an incision at or around the edge of the areola. The scar that is left is called a peri-areolar scar. Some breast surgeries also create a vertical scar from the nipple through the lower portion of the breast that may need to be camouflaged. The following are breast surgical procedures that may create a scar: Breast Augmentation or Enlargement (Augmentation Mammoplasty); Breast Reduction (Reduction Mammoplasty); Breast Lift (Mastopexy); and Male Breast Reduction (Gynecomastia).

Post-Surgical Areola Tattooing Techniques

Areola-Nipple Complex Simulation: This procedure is for patients who have had breast reconstruction after a mastectomy or lumpectomy. Cosmetic tattooing techniques and colour 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.

Waiting and Preparing For Your Procedure

Areola simulation or scar camouflage can be performed when your physician approves it. Dasha openly communicates with her patient’s surgeons and she follows all recommendations made by them. Scar camouflage can usually be performed as soon as 6 months after surgery, but you should first ask your physician. Once you have been cleared for areola tattooing, you can schedule your consultation with Dasha. During your consultation, she will discuss your concerns and recommend a treatment plan that she feels will provide optimum results. She will also provide you with specific guidelines to prepare for your procedure.

Post-Operative Instructions

During the first week after tattooing, your tattoo will look red and irritated and the colour may look much darker than you originally chose. Please be patient as the colour will fade as the skin begins to heal.

Redness, weeping, and oozing is all normal. Pain should be minimal but you may take Acetaminophen or Ibuprofen according to package instructions if needed. Increasing pain or pain not relieved by the above medications should be reported to your doctor immediately.

The tattoo area will slowly dry and peel. This is also normal and may take up to 3 weeks to heal completely.

You may resume all regular activity including eating, drinking and exercising immediately following your procedure.

You may shower immediately following your procedure but please refrain from soaking in water; including bath tubs, swimming pools and hot tubs for three (3) weeks.

Increasing pain, redness, red streaks, warmth, or fever should be reported to your doctor immediately.

Please make an appointment for a follow-up visit approximately 4-8 weeks after the initial tattoo.

This final phase of reconstruction often serves to transform the reconstruction into a breast that is truly your breast. This enables many survivors to lay their cancer burden down and move forward in life with restored femininity.