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

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

What is a nipple and areola tattoo?

A nipple and areola tattoo is a real tattoo of a nipple and areola on your breast. The tattoo is permanent (does not come off). It will help recreate your nipple and areola and is the last part of 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 your 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. To learn more, ask your healthcare provider or read Nipple Reconstruction.

If you do not have a nipple reconstruction procedure, you can get a 3D tattoo of a nipple. A 3D tattoo adds color and shading to your 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 tattoo?

A nipple and areola tattoo can be done after breast and nipple reconstruction surgery. You’ll need to wait at least 3 to 6 months after your final breast reconstruction procedure to get your tattoo. This will give your skin time to heal.

Who will do my tattoo procedure?

Nipple and areola tattoos are done by physician assistants (PAs) and nurse practitioners (NPs) with special training in tattooing. They have a New York City tattoo license. They use a handheld tattoo machine like the one used for other tattoos.

Does insurance cover my tattoo procedure?

Some health plans, including Medicare, may cover nipple and areola tattooing under certain conditions. Call your health insurance company for more information.

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 have nipple reconstruction, your skin needs to heal for least 6 months before your tattoo procedure. Your nipple reconstruction scar will not take color until it’s fully healed.

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

Make other changes to your breast before your 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 done before your nipple and areola tattoo procedure.

Get antibiotics for your tattoo procedure

The week of your tattoo procedure, your healthcare provider will send a prescription for antibiotics to your pharmacy. Antibiotics are medicines to treat or prevent infections.

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 medicines 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

After you change into a hospital gown, your PA or NP 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 your nipple and areola to be placed.
• What color would look most natural for your skin tone.

Then, your PA or NP will mix the tattoo ink until they make a color you both like. If you only have 1 breast reconstructed, they’ll try to match your natural nipple as closely as possible.

• If you had nipple reconstruction: Your PA or NP will tattoo the reconstructed nipple and a circular area to recreate the areola.
• If you did not have nipple reconstruction: Your PA or NP will use color and shading to make the tattoo look like a natural nipple. The tattoo will not 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 (medicine to numb your skin) can affect the color of your tattoo. Because of this, we do not recommend using it unless you need to.

How long will my tattoo procedure take?

Your tattoo appointment is scheduled for 2 hours.

Recovery after your nipple and areola tattoo procedure

After your PA or NP is done tattooing, they will place a dressing over the area. They’ll 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 or NP’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 forms on the tattooed area, do not peel it off. This can pull away the ink on your tattoo.
• After you take off your dressing, put non-scented white lotion or cream on the tattooed area. Put the lotion or cream on once a day for 2 weeks or until there’s no more scabbing. Examples of non-scented white lotion and cream are Lubriderm®, Aveeno®, Eucerin®, and CeraVe®.
• Do not exercise (such as running, doing yoga, or cycling) for 1 week after your procedure or while there’s scabbing. If you’re in physical therapy, it’s OK to keep going after your procedure.
• Do not lift anything heavier than 20 pounds (9 kilograms) for 1 week after your procedure or while there’s scabbing.
• Do not go swimming or soak in a pool, bath, or hot tub until your tattoo has fully 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.

Tattoo touch-up

You may need a touch-up procedure for your tattoo. The touch-up is done to add more detail to the nipple and areola, or more color to the areola. You’ll talk more about this with the PA or NP who does the procedure.