Overview

Nipple-areola tattooing restores colour to the areola (the area around the nipple). It can be done after breast reconstruction to help achieve symmetry and a more natural result. 

The aim of the procedure is to improve the cosmetic appearance of the breast by creating, as closely as possible, a nipple-areola that matches your existing nipple.

If you’ve had a double mastectomy we can tattoo a nipple-areola to the colour of your choice.

Choosing to have nipple-areola tattooing is entirely up to you. Many people who have had the procedure say it helped improve their body image, and self-esteem.

Risks of the procedure

As with all procedures, there are some risks to having a nipple-areola tattoo. 

• Infection after the procedure. Following the care instructions minimises the risk of infection. 
• Scarring.
• Slight skin irritation or allergy to pigment (colour). A patch test can be done if you have any allergies.
• Bleeding. You might bleed a small amount from the needle puncturing the skin. 

There is also a chance that you might not achieve the exact colour you want, or the colour being uneven. 

If you have any questions about these risks you can speak to the breast reconstruction clinical nurse specialist team. 

Other treatment options

Silicone nipple-areola prostheses are also another option. Your consultant can give you more information about this if needed.  

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have the procedure or treatment, we will ask you to sign a consent form. This says that you understand what is involved and agree to have the treatment.

Read more about our consent process.

Preparing for the procedure

If you've agreed to have the procedure, your consultant will refer you to the breast reconstruction clinical nurse specialist team.

You’ll be sent a letter with details of your appointment. Please let us know if you're unable to attend.  

Patch test  

It’s very unlikely that you’ll develop an allergic reaction to the pigments used in the treatment.

If you have any allergies, the nurse may recommend a patch test at least 24 hours before the procedure. This involves applying a small amount of pigment to your skin.

Reactions usually happen within 24 hours. If you have a reaction it might not be safe for you to have the tattoo. 

Signs of an allergic reaction include: 

• swelling or heat around the tattoo 
• a high temperature (fever)
• redness spreading from the area we applied pigment to. This might be harder to see on brown or black skin

During the procedure

The nurse will discuss the colour and size with you. They'll draw an outline of the areola on your skin using the pigment. Once you’re happy, the pigment is applied using a pen-like device with fast-moving needles that enter the skin at a depth of 2 to 3mm.

Different techniques can be used to build up colour and create of a 3D effect.  

The procedure usually takes about 30 minutes. 

When the tattoo is complete, a non-stick dressing is applied to the area to prevent rubbing from your bra or clothes.

Pain

Most people don’t feel pain during the procedure because the area is usually numb after breast reconstruction. If you still have sensation, we can apply a numbing cream beforehand.

After having the procedure

You may notice slight swelling and redness after the procedure, and the skin may feel tight. This usually improves within the first week, depending on how sensitive your skin is.

When you get home, remove the dressing and wear a loose fitting top with no bra. This allows any excess fluid to dry out. Apply a new dressing the next day, this helps prevent rubbing from your clothing and supports the early healing process.  

Looking after your tattoo

In the first couple of days the tattooed area may form a fine scab. Do not pick or peel off the scabbed area as this will remove the colour of the tattoo, and can cause scarring. 

The scab can last for a couple of weeks. You'll notice the pigment fade and soften as the scab comes away.

Washing and showering 

You can shower in the morning but try to avoid water directly hitting the treated area. Gently pat dry with gauze. If you want to bathe, avoid soaking the area in the bath water or using bath products. 

Resuming your usual activities 

Avoid swimming and using a sauna or jacuzzi for 2 weeks, as chlorine can act as a bleach which will change the appearance of the tattoo.

If you're using the gym within the first 2 weeks after the procedure, cover the treated area with a small amount of petroleum jelly beforehand to reduce any friction. Make sure the area is cleaned afterwards.

What to do if there's a problem

An infection is very rare, however if you have any symptoms it's important that you get medical help. 

Important information

Giving blood

The Red Cross advises not giving blood for 4 months after a tattoo.

MRI scans

Medical tattoos can show up as an artefact on the scan, and can cause a tingling sensation due to small amounts of iron oxide in the pigments. Please let the radiologist know that you have the tattoo before you have an MRI.  

Follow up appointments

You 'll need a follow-up appointment 4 to 6 weeks after your first treatment.

The nurse will assess the tattoo and discuss whether more pigment is needed. Most people need 2 treatments, as the colour fades over time. 

After you have had your treatments, you will discharged from the tattoo clinic.

The final result can last between 1 and 6 years. If the colour fades, your GP or breast care team can refer you back to the clinic.

Please let us know as soon as possible if you can’t attend your appointment so we can offer it to someone else.