Having a mastectomy following a breast cancer diagnosis is daunting, but breast reconstruction is now a popular option, with areola tattooing allowing for the creation of realistic breasts. Here’s what you need to know about this safe and confidence-inspiring procedure.

What Is an Areola Tattoo?
This is effectively the tattooing of an areola onto the breast area as a way to provide a more realistic impression.

What is Micropigmentation?
This is one of the most commonly performed areola tattoo treatments, also referred to as a cosmetic tattoo – which differs from permanent tattoo ink. The micropigmentation process involves using an electronic machine, using a cluster of micro-needles, to insert permanent tattoo ink or semi-permanent pigment into the upper layer of the skin for cosmetic reasons – in this case, for scar coverage and re-creation of the areola. All the needles used are sterile and disposable.

Is it Realistic?
When areola tattooing is performed by a qualified, experienced tattoo artist using high-end pigmentation, then the final result is extremely realistic. When sub-quality inks are used, the impression could be faded and patchy, lacking in definition. An experienced tattoo artist will incorporate creative techniques such as shading, perfectly matching the tone to your particular skin colouring and re-creating a 3D image of a nipple.

Who Performs an Areola Tattoo?
Many NHS hospitals will offer breast reconstruction patients the option of areola tattooing, but this would be performed by a nurse and there usually is a long waiting list, using semi-permanent pigments. However, the art of areola tattoo requires more than mere medical skills, which is why it’s often best performed by a licenced tattoo artist such as myself, who has sound knowledge of colour tones, differing skin types, and can re-create areola’s similar to the customer’s original look.

How Long Does it Take?
The actual tattoo time per areola is around 30 to 45 minutes, which includes the numbing, layout and pigmentation selection. With the consultation and after-care discussions, the procedure can take up to two hours to complete.

What Are the Risks Involved?
As with any treatment, there are certain risks, particularly if performed by an unlicensed or inexperienced practitioner. These could include:

Pigment spreading outside the areola area;
Uneven pigmentation;
Unsuitable pigment match to skin tone; or
Scarring, bleeding or infection if not properly treated.
There are also factors that will impact the final outcome, such as:

Natural skin overtones;
Skin characteristics such as oiliness, sun damage and dry skin;
Medication use;
Lifestyle choices such as smoking or alcohol use; and
Previous scarring.
What Does the Procedure Entail?
This starts with a consultation with myself, outlining what you’re wanting to achieve. If you’re having a bilateral areola tattoo, then a photograph of your original areola can assist. Alternatively, you will go through colour tones and location before settling on the final appearance.

You will arrive on the day with clean skin, making sure not to apply any type of moisturiser. Once you’ve signed a consent form, you’ll be taken to a private room where I will disinfect the skin and place a potent numbing cream, if needed, onto the area to be tattooed. The placement and pigment will be confirmed, design markings made, and the tattooing begins.

I will outline the aftercare regime, and a breathable dressing will be applied. During this time, a follow-up appointment will be made to check on the progress. It’s also worth noting that the colour may appear 50 to 80% darker and brighter than the final result for the first few days, but this will settle over time.

What Should I Wear to the Appointment?
It’s recommended that you wear a light top that is easily removed, preferably opening in the front. Wearing a comfortable bra is optional, although it can assist to keep dressings in place.

How Long Will the Tattoo Last?
There are many factors that will impact the longevity of the areola tattoo, but it’s important to remember that touch-up treatments are available. With micropigmentation, the colour will last about three to five years, and short treatment touch-ups can enhance the longevity.

Who Might Require an Areola Tattoo?
Areola tattoos are predominantly performed on post-mastectomy individuals, although there are many others will who benefit from areola pigmentation tattoos. This includes people who have undergone:

Breast augmentation
Breast lift
Male chest reconstruction
Keyhole surgery
Sex reassignment
Beyond this, areola pigmentation is also performed on individuals who simply like to darken the natural skin tone of their areolas, create a more defined look, or enlarge the appearance of the areola.

FAQs For Post-Mastectomy Tattoos
Every mastectomy is different which means it’s important to meet with a qualified areola tattooist such as myself for a thorough consultation to discuss your options. However, in the interim, here are some frequently asked questions about post-mastectomy tattoos.

As a way to mitigate the physical impact of a mastectomy, many NHS hospitals offer breast reconstruction surgery. During this procedure, surgeons can re-create breasts using a variety of complex techniques. However, often those who’ve undergone a mastectomy will lose both nipples in the process. This is where an areola tattoo is beneficial.

There is the option of nipple reconstruction surgery whereby the surgeon uses skin from the breast, or another part of the body, to rebuild a nipple on the breast. They will attempt to match size, shape and colour to the original.

Yes, this can be done, although the tattoo pigment might not work as well on a re-constructed nipple. However, the nipple and areola area can still be tattooed.

This will depend on the individual healing process, and you must consult with your health practitioner first, but it’s generally around six months after the mastectomy. This allows the area to heal, the swelling to go down and the scar tissue shouldn’t be as sensitive.

Benefits of Areola Tattooing
Often we don’t realise the impact of something until it is gone, and this is incredibly true for those who’ve undergone a mastectomy. Areola tattooing will:

Provide an extremely realistic impression of the original areola.
Instil a sense of confidence in yourself.
Provide a sense of finality to the cancer journey.
Mask any scarring from the surgery.
Free you from dealing with synthetic nipples.
The Areola Tattoo Healing Process
All bodies will heal differently, but with the proper aftercare, an areola tattoo will heal very quickly.

How Long Does it Take to Heal?
The healing process will take between seven and 10 days, with some form of light scabbing and skin flaking expected initially. Within two weeks, the area should be completely healed.

Aftercare Procedures
Your tattoo artist will give you a thorough overview of all the aftercare treatment you’ll require.

Generally, you’ll remove the dressing when you return home, allowing the area to dry.
The next day you can clean yourself but have to avoid letting water hit the area, as well as avoiding any soap and creams.
Wear light clothing and apply a daily dressing to prevent friction for the first 72 hours.
You must not pick at any scabbing as this can cause scarring.
It’s recommended that you do not swim, sunbathe, or use a sauna or jacuzzi for two weeks after the procedure to prevent pigment changes.
After two weeks, a thin layer of petroleum jelly can be used to create a barrier from the chlorine, which can cause the pigmentation to fade.
Is There a Follow-Up Appointment?
Yes, your follow-up appointment should be scheduled around six to eight weeks after the initial procedure. This will include an assessment of the area to ensure healing is complete, but it’s important to contact a health professional if you’re concerned, in any way, that the tattooed area is not healing correctly, or if there might be an infection.

Part of the follow-up appointment will be to confirm the colour and look of the areola tattoo are in line with what you expected. It’s necessary to top up the colour in the follow-up appointment too.

What to Consider Before Choosing a Tattoo Artist
As with any service, there are levels within the profession providing a range in terms of quality. When it comes to an aesthetic, specialised procedure such as areola tattooing, it’s vital that you’re treated by an experienced and licenced artist. This is not an area where you want to cut corners or opt for the most budget-friendly offer. When selecting a tattoo artist, you should:

Confirm the tattoo clinic is fully certified and that the tattoo artist is licenced and experienced.
Make sure you visit the tattoo clinic beforehand, taking note of elements like cleanliness and the professionalism of the therapist.
Check with the tattoo artist about their sterilisation practices.
Go for a consultation and make sure you are completely comfortable before scheduling your appointment.
Suki Su Permanent Natural Makeup is fully certified, and I take cleanliness and sterilisation extremely seriously before, after, and in-between every client that I see.

The results of an areola tattoo can be hugely impactful, both aesthetically and psychologically, providing a positive self-image. As mentioned earlier, partnering with the right tattoo artist will go a long way in ensuring the end result meets all expectations. I hope to partner with you for your areola tattoo treatment and help you achieve the results you are looking for.