Areolae repigmentation: after-cancer solution

Whatever type of permanent makeup a woman chooses, the goal is always the same: to enhance her natural beauty, to look more feminine and attractive. This is indeed very true for those women who have battled breast cancer, but their needs are quite special. Micropigmentation of areola complex, also known as Areolae repigmentation or Nipple tattooing, is the final step of breast reconstruction after the disease.

Areolae repigmentation can be performed after any type of breast cancer surgery, both lumpectomy (the removal of the tumor with the surrounding tissue) and mastectomy (the removal of the whole breast), as well as any type of the following breast reconstruction that would most often be:

  • Implant reconstruction;
  • Autologous or “flap” reconstruction: rebuilding a breast with the tissue from other parts of the patient’s body (back, thigh or belly).

In the above cases the natural areola complex is removed and the artist will have to “paint” a new one, matching the shape and color of the existent one, or recreating both of them if the surgery was bilateral. In case of nipple reconstruction the nipple can still be tattooed, but chances are the pigment won’t take well on it, thus follow-up visits will be needed to make sure the pigment retains.

Sometimes a nipple-sparing mastectomy is possible, when the areola complex is saved along with the skin around it. The natural areola in this case will look paler than it used to and the repigmentation will still be necessary.

The most popular procedure for the areolae repigmentation after breast cancer is Areola-Nipple Complex Simulation that implies Three Dimensional Cosmetic Tattooing technique. 3D nipple tattooing ensures the achievement of a highly realistic look of an areola complex by creating the optical illusion of “protrusion”. On a breast mound recreated without a nipple button this illusion is obtained by using different shades of color at the spots where the shadow from the nipple is normally cast.

Due to significant size of the areolae, it is possible that the use of 5 point needles (or higher) with different configurations will be needed. The tattooing starts at the periphery of the areola moving to the centre with slow careful strokes. The areas along previous scars, the areolar border and the nipple projection require the most attention as the pigment takes there with difficulty. Endpoints contribute to the pigment injection in the deep layers of dermis or punctuate bleeding. After the procedure the leftover pigment is painted on the raw surface to ensure the sufficient amount of the color that might be taken up by the tissues. Please keep in mind, that details described in this article are optional. Each and every artist has his own personal techniques, instruments and preferences.

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