The general condition for performing areolae repigmentation after breast cancer is for the scar tissue to be mature and healed, since tattoo needles are traumatic for the epidermis and dermis as they produce multiple small wounds in the skin. To perform areolae repigmentation the average recovery period after a successful breast surgery should be somewhere from 5 to 12 months, however the healing process is individual for every person, so the initial consultation will help to set the right timeframe.
At the first appointment the artist asks what the patient remembers about her areolae before cancer. For bilateral areolae recreation old pictures can be brought in, but aren’t vitally necessary. After mixing hypoallergenic pigments the artist suggests the shade that looks the most natural on the patient’s skin; the patient’s height, proportion and the breast size that the doctor has given her when having redone her breast mound after mastectomy are also taken into account when recreating the areola.
For unilateral areola recreation spot color test is scheduled as an extra appointment in order to ensure the closest color match to the existing areola as the color may initially be affected by the patient’s skin tone and her body chemistry. Usually the artist requires 4-6 weeks to pass after the color test before the actual tattooing to allow for healing and color stabilization.
The second appointment, which is the actual implanting of the pigment into the skin, takes approximately 30-40 minutes per breast. In the majority of cases the procedure gives minimal discomfort to the patient as the natural areola with its sensitive nerve ends is removed. Some topical anesthetic can still be applied if needed. Most importantly, patients must be warned against putting on their own numbing crème before the appointment. Occasionally a touch-up visit is necessary to achieve the desired color.
The areolae repigmentation aftercare is minimal. The tattooed area is covered with non-stick pads that are left in place for up to 5 days. After the pads have been removed the patient is instructed to do hygienic washing with soap and water. An antibacterial ointment and/or Vaseline or A and D ointment should be applied abundantly on the tattooed area for 7 days to keep it moisturized during its epithelialization. Sport, swimming and taking baths is restricted for the healing period. With these conditions observed the healing process should normally take up 10 days. The patient should be reevaluated in 6-7 weeks for skin scabs or pigment loss.