It used to be tattoos brought to mind far away cultures or sailors on shore leave. Not so much anymore. From rock stars to soccer moms, tattoos are everywhere now, and in terms of their sophistication and artistry… well, they’ve come a long way since “I ❤️mom.” In the past decade, tattooing for some women has even become integral to their recovery from breast cancer. We’re talking about nipple tattoos, some of which are remarkable in their anatomical detail, color matching, and 3D shading.

For years Dr. Slack has believed that tattooing is a viable option for women after breast reconstruction (as long as they have fully healed). It can be done instead of nipple reconstruction or in addition to the procedure. For women who are undergoing breast reconstruction following mastectomy, the cost of nipple tattooing is often covered by insurance.

To understand where tattooing and breast reconstruction come together, you first need a little background on how breast reconstruction is typically done.

It is sometimes possible to spare a woman’s nipple when performing a mastectomy, however, most of the time the darker, sensitive skin of the nipple and areola is removed entirely. When the breast is then reconstructed, the first stage is to create a breast mound (without nipple), using grafted tissue from her own body or a breast implant. Depending on the extent of the cancer and the degree of tissue removed during the mastectomy, this may require more than one surgical procedure.

Once the breast mound is complete and fully healed, the question of the nipple can be addressed. There are several options here: no nipple, surgically reconstructed nipple with or without tattooing, or 3D nipple tattooing.

Some women choose to go without a nipple (reconstructed or otherwise), being most concerned with their breast appearance under clothes. You can see some before and after images of this in our breast reconstruction gallery. Prosthetic (or stick-on) nipples are an option for these women.

A nipple and areola can also be recreated surgically, using grafted tissue from the woman’s own body. Typically with reconstruction, the new nipple does not have the same color characteristics that the woman had before. For those who want a more natural looking nipple, Dr. Slack offers tattooing in his office. He has a specially trained cosmetic tattooist who can ink in the missing color, usually darker for the nipple and lighter for the areola. This is typically done about six weeks after surgery, to ensure all incisions are well healed.

For women who want the appearance of nipples, but don’t want surgery, 3D nipple/areola tattooing is a good option. For this, Dr. Slack refers his patients out to medical tattoo artists. He has several in the Dallas area that he trusts who do remarkable work. You can also find a listing or artists online at Pink Ink Project, 3D Nipple Areola Tattooing. They recommend taking a look at the tattooist’s before and after photos before making a choice.

Even though 3D tattooed nipples are actually flat and lack dimension, many women say they look as good as the real thing. According to a study published in the journal Plastic and Reconstructive Surgery, professional nipple tattooing can result “in a more realistic and three-dimensional reconstruction that can appear better than surgical methods. The application of three-dimensional techniques or ‘realism’ in tattoo artistry has significant potential to improve the aesthetic outcomes of reconstructive surgery.”

If you want to learn more about breast reconstruction and whether tattooing may play a role for you, schedule a consultation with Dr. Slack today.