🔴Nipple tattooing is available to some women after a mastectomy

🔴It's performed if doctors cannot save the nipple and areola after surgery

🔴The 3-D nipple tattoos are real and permanent and look natural

If one or both of your nipples were removed after a mastectomy, women can choose to have tattooing to create the nipple and areola (the dark area around the nipple).

Jaclyn Trotta, Rutgers-Robert Wood Johnson Medical School
Jaclyn Trotta, Rutgers-Robert Wood Johnson Medical School

What is nipple tattooing?

It is a real permanent tattoo of a nipple and areola. It’s for women who had to undergo a skin-sparing mastectomy, meaning that doctors were not able to save the nipple during surgery, either for oncological purposes or anatomic purposes.

“As a result, we give them this option as their last stage of reconstruction to tattoo a nipple and areola so they feel a sense of completeness after their reconstruction,” said Jaclyn Trotta, a certified physician assistant in the Division of Plastic and Reconstructive Surgery at Rutgers-Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital.

3-D nipple tattoos are real tattoos, applied with needles that insert pigment into the skin. A tattoo artist can create an amazingly realistic image of a nipple that appears to have physical dimension but is really flat to the touch.

With a regular tattoo machine, Trotta said surgeons use stenciling and shading techniques to create the 3-D effect of the nipple and areola.

Nipple tattoo equipment at Rutgers-Robert Wood Johnson Medical School
Nipple tattoo equipment at Rutgers-Robert Wood Johnson Medical School

The procedure

The procedure is done in the office. No local anesthesia or numbing medication is needed, she said. Trotta said it usually takes about an hour per breast. Since the tattoo is real, it should last a lifetime. But she said women may have to get some touch-ups due to fading every few years.

When should nipple tattooing occur?

Surgeons typically want women to wait at least three months after their final breast reconstructive surgery. Trotta explained that there could be several reconstructive surgeries needed, and the tattooed nipples and areolas are the final stage in the breast reconstructive process.

“It also depends if the woman has undergone radiation after surgery. We may want to wait a little bit longer after their skin is more healed, so they have better skin quality and integrity for the tattoo,” Trotta said.

Tattoo equipment used for nipple tattooing at Rutgers-Robert Wood Johnson Medical School
Tattoo equipment used for nipple tattooing at Rutgers-Robert Wood Johnson Medical School

Nipple Reconstruction

Instead of nipple tattooing, some women undergo nipple reconstruction. That’s where surgeons take skin flaps on top of the breast and make a small prominence which would be their new nipple. Then, surgeons can tattoo around that nipple so it’s a 3-D effect.

The main advantage of nipple reconstruction is that it will project out from the breast. Some women feel this creates a more natural look. However, a reconstructed nipple will flatten and lose most of its projection over time.

Pros and Cons of Nipple Tattooing

Women have been through so much with their many breast reconstructive surgeries and treatment. It’s a very gratifying feeling that at the end of their process, they receive a nipple and areola, which gives them a sense of wholeness and completeness afterward, Trotta said.

But keep in mind, that this is still a procedure, meaning there is always a small risk of infection and asymmetry. The nipple may fade over time so women may have to come in a few times throughout the years for touch-ups to keep it nice and dark.

woman with breast cancer head covering

I don’t want a tattoo

Women who have had breast reconstruction with an implant or tissue flap are candidates for nipple tattooing. But if radiation treatments damaged the breast skin or the skin became too thin when tissue was removed, they may not be a candidate. There are also women who simply do not want tattoos.

Prosthetic or stick-on nipples or temporary nipple tattoos are other options. With the prosthetics, they look like natural nipples, but they can be put on and taken off whenever you like.

It’s always important to check with your plastic surgeon about the options available to you before, during, and after any breast reconstructive surgery.

Report a correction 👈 | 👉 Contact our newsroom

Solve these picture puzzles

Convert these pictures/Emoji into the correct responses. These pictures are NOT describing the answer — they're telling you which words and sounds to say. The answers are at the bottom.

Gallery Credit: Dino Flammia



More From New Jersey 101.5 FM