Breast Cancer: Nipple Tattooing

Breast cancer throws a curveball into your life, forcing you to make decisions you never thought you’d face. For instance, you might choose to have a mastectomy as part of your treatment. This procedure removes 1 or both breasts, including the nipple.

Life post-surgery comes with a new set of choices. This is especially true if you decide to have breast reconstruction. One big choice you'll have to make: Deciding how (and if) you want to recreate the nipple and areola.

What are my options?

Plastic surgeons often advise waiting a few months after breast reconstruction surgery to have nipple tattooing done. When it comes to nipple tattoos, you have 2 main choices: a nipple reconstruction tattoo or a 3-D nipple tattoo. Here’s a closer look at both:

• Nipple reconstruction tattoo. First, your plastic surgeon will take skin and tissue from your breast and create a new, raised nipple. The goal is to match your other nipple as closely as possible. Once the skin heals, you’ll get a tattoo to give it color and texture for a natural-looking finish.

• 3-D tattoo. This is a “picture” of a nipple and areola that’s tattooed to your breast. Think of it as an optical illusion. It’s flat to the touch, like a normal tattoo, but looks 3-D. The tattoo will have fine details, shading, and coloring to mimic things like the little bumps that appear on your areola (called Montgomery glands). This process is less invasive than nipple reconstruction.

There is also a third option: temporary nipple tattoos. You apply them to your breast with a wet cloth. Just keep in mind that these aren’t permanent. They only last a couple of weeks.

Where to go for a nipple tattoo?

You may be able to get both types of nipple tattoos done at a plastic surgeon’s office or at a hospital. If you’d prefer to go to a nipple tattoo artist’s studio, it’s best to get your plastic surgeon’s OK first. They can let you know when it’s time to move forward with that step. Ask if they recommend any specific tattoo artists.

What's involved in the tattooing process?

• Reference points. If you still have 1 of your natural nipples, your tattoo artist can match your new nipple’s color and size to it. But if both were removed during your mastectomy, bring a photo of your breasts from before surgery. This is a good starting point for figuring out your new nipple’s size, shape, placement, and color.

• Color selection. The artist will ask for your input on the colors for your nipple and areola. Remember, nipples come in all sorts of shades of pink, tan, beige, and brown. Looking through the options, you’ll want to find one that looks natural and fits your skin tone. Ask them to apply a temporary swatch of color to your breast skin. That way, you can see what it looks like in different lighting.

• Prep work. To help figure out placement, the artist may place silicone prosthetic nipples on your breasts. They’ll also draw markings on your breasts. This lets you see the location, size, and shape of your new nipples and areolas.

• Tattoo duration. The tattooing itself often takes about 30 minutes for each nipple. After a mastectomy, most women don’t have feeling in their breasts. You should have little to no pain or discomfort. But you may feel pressure or vibration during the procedure.

How much does a nipple tattoo cost?

Actual costs for this procedure may vary. Be sure to check with your insurance company to see if it is covered under your plan. Some plans may cover nipple tattooing. Medicare may pay for it, too. Medicaid coverage varies state to state.

If you have your nipple tattoo done at a plastic surgeon’s office or hospital, they should submit the insurance claim for you. If you go to a tattoo artist’s studio, you will have to pay up front and submit the claim yourself for reimbursement.

What is it like to recover from a nipple tattoo?

After the artist finishes your tattoo, they’ll cover it with a protective, waterproof dressing. Ask how long you need to wear the dressing. Usually, it should stay on for a few days.

Follow any instructions you are given for bathing, skin care, and changing dressings. Be sure to ask what activities you should avoid and for how long. Also ask what concerning symptoms to watch for and when to report them. Things like fever, pain, redness, warmth, or drainage around the tattoo area could all be signs of an infection.

Your journey, your choice

There is no right or wrong answer when it comes to nipple tattoos. Only you can make the decision about what makes you feel most comfortable and confident in your body. Your healthcare team will be there to support and guide you through your choice.