About Your Nipple and Areola Tattoo Procedure: What You Should Know

This information will help you get ready for your nipple and areola (the circle around your nipple) tattoo procedure at MSK.

What is a nipple and areola tattoo?

A nipple and areola tattoo is a real, permanent tattoo of a nipple and areola on your breast. The tattoo will help recreate your nipple and areola and complete your breast reconstruction.

What is the difference between a nipple reconstruction tattoo and a 3D tattoo?

A nipple reconstruction is a procedure to rebuild and raise your nipple. If you have this procedure, skin and tissue from the breast are used to form a new, raised nipple. Later on, the reconstructed nipple is tattooed with color and an areola is tattooed around it. For more information, ask your healthcare provider or read Nipple Reconstruction.

If you don’t have a nipple reconstruction procedure, you can get a 3D tattoo. A 3D tattoo adds color and shading to the breast to make the nipple look like it’s raised. The tattooed nipple is flat to the touch, like a normal tattoo, but looks like a natural nipple.

When should I get my nipple and areola tattoo?

A nipple and areola tattoo can be done after breast and nipple reconstruction surgery to treat breast cancer. It can also be done after a preventive mastectomy.

You’ll need to wait at least 3 months after your final breast reconstruction procedure to get your tattoo. This will give your skin time to heal.

Who will perform my nipple and areola tattoo procedure?

All nipple and areola tattoos are done by specially trained physician assistants (PAs) with a New York City tattoo license. They use a handheld tattoo machine like the one used for other tattoos.

What To Know Before Your Nipple and Areola Tattoo Procedure

Nipple and Breast Reconstruction

If you plan to have nipple reconstruction, you’ll need to have it done before your tattoo procedure. Having nipple reconstruction after your tattoo procedure will affect the quality of your tattoo.

If you had breast reconstruction surgery on just 1 of your breasts, we’ll only tattoo that breast. We can’t change the color or size of your other natural nipple or areola. We will try to make both areolas as similar as possible.

Make Other Changes to Your Breast Before Your Nipple and Areola Tattoo Procedure

Talk with your plastic surgeon if you want to make any other changes to your breast. This includes changing the position of your implant, changing the type of implant, or making a scar less visible. In most cases, you’ll need to have these procedures before your nipple and areola tattoo procedure.

Getting Your Antibiotics for Your Nipple and Areola Tattoo Procedure

The week of your tattoo procedure, your healthcare provider will send a prescription for antibiotics to your pharmacy. Pick up your prescription before your procedure. If your pharmacy does not have your prescription by the day before your procedure, call your surgeon’s office.

The Day of Your Nipple and Areola Tattoo Procedure

Things To Remember

• Take your antibiotics 1 hour before your procedure. If you have questions about your antibiotics, call your healthcare provider’s office.
• Take your daily medications as usual, including blood thinners.
• You can shower the morning of your procedure. Do not put any lotion, cream, oil, or powder on your skin from your waist up.
• Wear a loose-fitting, comfortable top. You may also want to wear a loose-fitting bra to avoid putting pressure on the tattoo.
• Arrive on time. If you arrive more than 15 minutes late, your appointment may be rescheduled. We want to give each patient enough time and attention for the best tattoo results.
• There’s a high demand for this procedure. If you need to cancel or reschedule your appointment, please let us know as soon as possible.

What To Expect When You Come to the Hospital for a Nipple and Areola Tattoo

After you change into a hospital gown, your PA will talk with you about:

• Any concerns you have about pain during your tattoo procedure.
• What you want your nipple and areola to look like.
• Where you want it to be.
• What color would look most natural for your skin tone.

Then, they’ll mix the tattoo ink until they make a color that you both like. If you only have one breast reconstructed, your PA will try to match your natural nipple as closely as possible.

If you had nipple reconstruction, your PA will tattoo the reconstructed nipple and a circular area to recreate the areola.

If you didn’t have nipple reconstruction, your PA will use color and shading to make it look like a natural nipple. The tattoo won’t be raised but will look 3D.

What does getting a nipple and areola tattoo feel like? Does it hurt?

After your mastectomy, it’s common to have lost feeling in your breasts. Most people only feel pressure or vibration during their tattoo procedure. Topical anesthetic can affect the color of your tattoo, so we don’t recommend using it unless you need to. A topical anesthetic is medication you put on your skin to make an area numb.

How long will my nipple and areola tattoo procedure take?

Your tattoo appointment is scheduled for 90 minutes.

Recovery After Your Nipple and Areola Tattoo Procedure

After your PA is done tattooing, they will place a dressing over the area. They will teach you how to care for your tattoo and give you the resource Instructions for After Your Nipple and Areola Tattoo Procedure. Follow your PA’s instructions and these guidelines:

• You can shower as usual with your dressing on. It’s waterproof.
• Take off your dressing 4 days after your procedure.
• If a crust or scab appears on the area, don’t peel it off. This can pull away the ink on your tattoo.
• After your dressing is removed, apply to the tattooed area non-scented white lotion or cream (such as Lubriderm®, Aveeno®, Eucerin®, or CeraVe®). Apply the lotion  once a day for 2 weeks or until there’s no more scabbing.
• Don’t exercise (such as run, do yoga, or cycle) for 1 week after your procedure or while there’s scabbing. If you’re in physical therapy, it’s OK to continue after your procedure.
• Don’t lift anything heavier than 20 pounds (9 kilograms) for 1 week after your procedure or while there’s scabbing.
• Don’t go swimming or soak in a pool, bath, or hot tub until your tattoo has completely healed. This usually takes about 2 weeks.
• You can take acetaminophen (Tylenol®), extra strength acetaminophen (Extra Strength Tylenol®), or ibuprofen (Advil®) to help with pain or discomfort.
• It’s safe to have magnetic resonance imaging (MRI) scans and other imaging tests done after your tattoo procedure.