Breast Reconstruction

Areola Tattooing

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A breast cancer survivor may undergo breast reconstruction surgery and still not feel whole due to a lack of nipples and/or areolas on the front of the breast. In many cases, nipple and/or areola tattooing can help a woman feel more complete and natural after surgical reconstruction. If this sounds like you, Dr. Christine Fisher and her medical tattooing team can help put the finishing touch on your reconstruction, whether you have implants, a living tissue reconstruction or a combination of the two. For many patients, areola tattooing can feel like the final piece of the puzzle after completing treatment for breast cancer.

What is an Areola Tattoo?

An areola tattoo is a way to construct a nipple and/or areola on a reconstructed breast for an entirely natural appearance. Many women are surprised by how much the lack of an areola can affect self-confidence, feelings of health and overall quality of life. Fortunately, patients can now restore this portion of the breast with a natural-looking and beautiful tattoo. Our medical tattooists use similar techniques to those of traditional tattoo artists, but take additional care in blending and feathering the pigment to create a photo-realistic result.

Areola tattooing is not restricted to women who have had non-nipple-sparing mastectomies; even if you were able to preserve your nipples and areola during the breast reconstruction process, you may have surgical scars that can be visually corrected with a tattoo to create areola that are symmetrical and consistent in color.

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Discover whether areola tattooing from Austin, TX, plastic surgeon Dr. Christine Fisher is right for you. Call Christine Fisher MD at (512) 815-0123 or send a message online to arrange a consultation.

Is Areola Tattooing Right for You?

Even though areola tattooing can help women feel more “whole” post-reconstruction, some do not pursue this procedure because they don’t believe it’s essential. However, the lack of an areola can be distressing for many women and can negatively impact feelings of femininity as well as physical intimacy with a partner.

Areola tattooing is an option for nearly every woman who has undergone breast reconstruction. Even patients who have not had their reconstruction performed by Dr. Fisher can come to our practice to get a beautiful, 3-dimensional looking result from our highly trained medical tattooing team. Our team will assess your case carefully to determine if this procedure is the right option for you given your goals.

Options in Areola Reconstruction and Tattooing

There are a variety of options in areola tattooing, depending on your specific situation and concerns:

Nipple-Areola Simulation

This procedure is performed for women who have undergone breast reconstruction without surgical nipple reconstruction and would like to add a nipple and areola to their new breast(s). If both breasts require simulation, the medical tattooist will work with you to develop a blend of pigment you are satisfied with. It might be similar to the color of your areola before mastectomy, or could be a different tone, depending on your preferences. If just one breast was affected, the tattooist will mix a pigment that matches your native areola. Tattooing that simulates the protrusion of a nipple is called three-dimensional or “3D” areola tattooing.

Surgical Nipple Reconstruction with Areola Tattooing

If you had surgical nipple reconstruction, you may choose areola tattooing to complete your look. Dr. Fisher may perform nipple creation at the time of your breast reconstruction, using skin and tissue from the top of the mound of the newly constructed breast to create a protruding nipple. After you’ve healed from surgery, you can then have areola tattooing to bring pigment to the reconstructed nipple and surrounding skin.

Christine Fisher, M.D.

Christine Fisher, M.D.

  • Known for natural-looking aesthetic results in breast reconstruction and cosmetic surgery.
  • Elected by her peers for inclusion in Texas Monthly's Texas Super Doctors®: Rising Stars listing.
  • Reconstructed over 1,500 patients, including more than 500 DIEP flap reconstructions.
  • 4.9-star average rating over hundreds of reviews for cosmetic surgery.
  • American Society for Aesthetic Plastic Surgery (ASAPS)
  • American Society of Plastic Surgeons (ASPS)
  • American Society for Reconstructive Microsurgery

Scar Camouflage

Nipple-sparing mastectomy can be a good option for many women, but sometimes the areola can sustain scarring due to the cancer treatment and reconstruction process. In these cases, areola tattooing can be helpful in camouflaging the scars to produce rounder, more symmetrical areola. Color differences can also be corrected during this process.

Adjustment to Color or Size of the Areola

Whether your areola was altered after a nipple-sparing mastectomy or you are unhappy with an areola tattoo done elsewhere, our tattooing team can make adjustments to the color or size of your areola to make it look more natural and proportionate to the rest of the breast. Color adjustments can also be performed for women who have seen changes after breastfeeding or have a skin discoloration disorder like vitiligo.

When Should I Consider an Areola Tattoo After My Mastectomy?

You will need to wait until you are fully healed from your reconstructive surgery before pursuing areola tattooing. For most patients, this is about three to four months after surgery. If you want tattooing to camouflage a scar on the breast or areola, you may need to wait up to six months to avoid the risk of additional scarring. However, areola tattooing can be done at any point after the healing process is complete. Even if your reconstruction surgery occurred years ago, we encourage you to schedule a consultation at our office to find out if an areola tattoo post-mastectomy is the right choice for you.

Download Our Breast Reconstruction Post-Operative Care Guides

We've compiled detailed post-operative care instructions to best equip our breast reconstruction patients throughout their recovery process. To ensure the best and safest recovery, your plan encompasses appropriate prescriptions and clear directions towards maintaining your comfort to get you back to normal life and activity as soon as possible. Individual patients respond uniquely, and the type of procedure may differ, but these basic guidelines will help you along your journey.

Download Post-Operative Care Guides

About the Procedure

Areola tattooing is performed in our office by our experienced medical tattooist. If you lost sensation in the breast after your reconstruction, you will not likely feel anything during the tattooing process. However, topical numbing is available for those who do have some sensation and are concerned about their comfort level during the procedure. Your pigment will be carefully mixed to match the color you want, and an outline of the areola will be drawn on your breast. Special tattoo instruments will then be used to apply the pigment to the skin via fine needles. The entire process is relatively quick, taking 45 minutes to an hour.

Care After Areola Tattooing

Areola tattooing aftercare is relatively simple. When your tattooing session is over, your artist will place non-stick pads over the areolas to protect them as they heal. You will be instructed to apply a thin layer of A&D ointment twice a day for the first two days. During this time, it’s also best to avoid strenuous exercise that could cause heavy sweating or friction on the breasts. Hot tubs, Jacuzzis and swimming pools should be avoided for a week, and you should not go into the ocean for at least two weeks.

The color of your areolas will likely be darker than you want at first; rest assured this is normal and the color will fade to a more natural look over the first four to six weeks. Flaking is also common in the first three to five days after your procedure and should not cause concern. If you have any significant pain, redness, swelling or oozing around the areola, you should contact our office right away to schedule an assessment as these symptoms could indicate an infection.

Discovering Wholeness Once Again

Some patients do require a second tattooing session to touch up the first treatment and adjust the color slightly. In most cases, the result will last for many years. The pigment from tattoos does tend to fade over time, so it is possible you will need another session years later to add a bit more color to the areola. Women who undergo areola tattooing are usually pleased with their results and find the process is the final step in reclaiming their health and their bodies. To learn more about this procedure, contact Dr. Fisher’s office today at 512-815-0123.

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