Nipple-areola tattooing is a procedure in which a tattoo artist or plastic surgeon recreates the nipple and areola after breast reconstruction surgery.

Nipple reconstruction involves recreating a nipple using small pieces of skin from the reconstructed breast. A few months later, a surgeon can recreate the areola using tattoo ink.

Those who do not want to undergo nipple reconstruction can instead opt for a realistic image of a nipple by a tattoo artist.

Although some people feel that nipple reconstruction, whether from surgery or tattooing, is an important step to move forward, others do not. In the end, the choice is completely up to the individual.

This article discusses what a 3D nipple-areola tattoo is, the benefits and risks of getting one, and tips on aftercare and recovery.

Nipple-areola tattooing is a cosmetic procedure to help recreate an individual’s nipple.

Although nipple reconstruction is a popular choice for many, some people may decide to get permanent 3D nipple tattoos instead.

An experienced tattoo artist can create images of highly realistic-looking nipples. These tattoos will appear to be 3D but will be flat to the touch.

For those who have undergone a unilateral mastectomy, it is possible to match the color, shape, and texture of the existing nipple.

This procedure typically follows breast reconstruction surgery, but some individuals may use tattooing after nipple reconstruction surgery to add color or make their new nipple or nipples appear more realistic.

Nipple tattooing offers a less invasive alternative to surgery.

The American Cancer Society (ACS) suggests waiting 3–4 months after breast reconstruction surgery to get nipple reconstruction or nipple tattoos. Some tattoo artists and studios may prefer that you wait 4-6 months after surgery before having nipple tattoos. This will give the new breast or breasts time to heal properly.

Having a visual consultation with the tattoo artist may be necessary in order for them to confirm that the skin has healed enough.

If a person has any known allergies, they may have to undergo a skin allergy test 24 hours before the procedure. This involves applying a small amount of pigment to the skin and seeing whether or not there is a reaction.

On the day of the procedure, the person should arrive with clean skin. Also, the tattoo artist may ask them to avoid applying moisturizer on the night before or morning of the procedure.

They may also recommend that the person wears a loose-fitting shirt that opens in the front. Some facilities may provide gowns or robes for people to change into.

The tattoo artist may ask the person to sign a consent form or fill out a health questionnaire beforehand.

A person can expect the entire appointment to take 1–2 hours.

Before tattooing, the tattoo artist will discuss the colors, placement, and size with the person getting the tattoo.

If the person has one of their natural nipples, the artist will match the size and color of that. If the person has had both nipples removed, it may be beneficial to bring in a picture from before the surgery.

To determine the color, they will look at a palette of pigments, including varieties of pinks, browns, purples, tans, and beiges.

After mixing the pigments, the tattoo artist will apply a small amount to the skin so that the person can see how it looks in different lighting.

To help decide on the placement, the tattoo artist may use a silicone nipple. They will then draw markings to show the location, shape, and size of the new areola.

It can take approximately 30 minutes to tattoo one nipple.

Once the procedure is complete, the artist will apply a bandage to the tattoo. It usually takes 7–10 days for a nipple tattoo to heal. However, for skin that is thinner, healing can take up to a few weeks.

Once the tattoo is complete, the color is typically darker and more intense. The tattoo will lighten slightly as it heals. However, after 1–2 months, there should be no further color change.

Following the tattoo artist’s aftercare instructions will help the tattoo heal faster.

During recovery, a person should avoid chlorinated pools, bathtubs, hot tubs, and direct sun exposure. People can also apply antibacterial ointment to the area to prevent infection.

The reconstructed breast will not have the same sensations as before the mastectomy. As a result, the tattooing is not usually painful.

However, some people may experience mild discomfort or pain.

A person may opt to get a nipple tattoo as an alternative to undergoing surgery. This prevents the creation of new scars. In addition, the healing and recovery process is easier than that of nipple reconstruction.

Some people find that the results are better than if they had undergone nipple reconstruction surgery. This is because the tattoo can include fine details, coloring, and shading that may it look more realistic.

However, similar to getting a traditional tattoo, getting a nipple-areola tattoo carries a few risks, which can include:

  • allergic reactions
  • infections
  • granuloma, which is a small area of inflammation
  • keloids, which are raised scars
  • dissatisfaction with the final result

Although the procedure is common and well-tolerated, some people may experience a delayed hypersensitivity reaction. This is otherwise known as a delayed allergic reaction.

A person in a 2019 case study experienced a delayed reaction 7 weeks after the procedure despite having no reaction in the skin allergy test.

A person interested in 3D nipple tattooing should speak with a healthcare professional about any potential risks.

A person can get a nipple tattoo from a member of staff at a plastic surgeon’s office or a qualified nipple tattoo artist.

Finding an artist who specializes in permanent areola and restorative tattooing is an important first step to getting a nipple-areola tattoo.

Although some individuals may have a tattoo artist in mind, others may ask a doctor, surgeon, or local cancer support group for advice or referrals.

Once they have found a potential tattoo artist, the person may find it beneficial to ask to see a portfolio of the artist’s work. They can also ask about the sterilization practices the artist uses and whether or not they have a private room for tattooing.

Although the cost of nipple tattooing varies, the average cost of one tattoo is around $350. A person can expect to pay $600–$800 for both nipples.

The Women’s Health and Cancer Rights Act (WHCRA) of 1998 requires group health plans and individual health insurance policies that offer mastectomy coverage to pay for all stages of reconstruction surgery. This includes any additional procedures a person may need to treat further complications.

Medicare often covers nipple-areola tattooing, while Medicaid coverage varies from state to state. Insurance may not cover nipple tattooing if an independent tattoo artist performs the procedure.

A person may not be eligible to get nipple tattoos if they:

  • have undergone radiation treatments that have damaged the skin
  • have breast skin is too thin
  • have lymphedema involving the chest
  • have a history of infections in the area of the breast

If a person does not want to undergo nipple tattooing or is unable to do so, other noninvasive options are available. Other types of nipple reconstruction include the following.

Prosthetic nipples

People who cannot or do not want to get nipple reconstruction surgery or nipple tattoos may want to try prosthetic, or stick-on, nipples.

According to the ACS, prosthetic nipples are made of silicone and look and feel like real nipples. Some prosthetic nipples are self-sticking, while others come with a special skin adhesive.

Prosthetic nipples come in a variety of sizes, colors, and projections.

Temporary nipple tattoos

People who are apprehensive about getting a permanent tattoo can opt to use temporary nipple tattoos.

Temporary nipple tattoos are easy to apply and are removable with rubbing alcohol. Temporary nipple tattoos can last for 1–2 weeks, depending on the brand a person uses.

Nipple-areola tattooing is a procedure in which a medical specialist or experienced tattoo artist recreates the appearance of a person’s natural nipple.

Although flat to the touch, these tattoos appear 3D and realistic.

Many people opt to undergo some form of nipple reconstructive, but the choice itself is up to the individual.