What to Know About Nipple Tattoos, Prosthetics, and Reconstruction

After a mastectomy, 3D nipple tattoos are often used instead of nipple reconstruction. It offers breast cancer survivors who want nipples a very realistic and less invasive alternative.

They’re designed and performed by tattoo artists in shops and in some specialized medical centers. The practitioner uses an oscillating tattoo needle coated with pigment. The pigment is inserted into the skin to create the appearance of a nipple.

Here’s what you can expect when you go for a nipple tattoo.

Finding a qualified nipple tattoo artist

Asking others who have had nipple tattoos for a recommendation is a good start. If you don’t know anyone personally, you can reach out to members of a local breast cancer support group or your cancer center.

There are plenty of tattoo artists offering nipple tattoos, so doing an online search should give you a few options to choose from.

You’ll also want to do some homework to make sure you find someone you’re comfortable with and who has experience doing nipple tattoos.

Here are some things to consider before choosing a tattoo artist:

• Visit different tattoo shops, taking note of cleanliness, atmosphere, and professional and friendly staff.
• Make sure that the artist and establishment have the proper licensing.
• Ask if the artist practices nipple tattoos outside of the shop, as some artists also work with local breast surgery centers and cosmetic surgery clinics.
• If privacy is a concern, look for a shop that has a private room for tattooing or an artist who also works at a medical facility.
• Ask the artist about their sterilization practices.
• Ask to see a portfolio of the artist’s previous nipple tattoos, not just their artistic tattoos.

Consultation

Prior to the procedure, you’ll meet with the tattoo artist for a consultation. During that time, you’ll discuss size, placement, and pigment colors. The tattoo artist will want to see the area they’ll be working on to determine the best way to proceed.

They’ll then create a plan based on your preferences, variables (like your scar patterns), amount of scar tissue, and skin thickness. You’ll also be given instructions on how to prepare for the procedure.

The day of

On the day of your procedure, you should arrive showered with clean skin. Don’t apply moisturizer or any type of numbing agent.

Be sure to have a bra or camisole with you to help hold your bandages in place. You should also wear a loose, comfortable shirt that opens in front to wear during the procedure. Some shops have robes or gowns you can change into.

You’ll then be given a consent form to sign and possibly a health questionnaire to fill out.

Next, you’ll be taken to a private room where you’ll undress and lie down on an adjustable bed or chair for your tattoo. The artist will disinfect the skin being tattooed.

During the procedure

Before starting, the artist will go over placement and pigment again. Design markings will be made, and once you approve, the tattoo will be applied.

The entire tattoo time, including placement and pigment mixing, varies among artists. It can take one to three hours, depending on whether you’re having one or both breasts done.

The actual tattooing only takes 15 to 30 minutes per nipple.

Aftercare

Once the procedure is complete, a bandage will be applied over the tattoo. Healing can take a week to 10 days. You can expect some mild scabbing or flaking.

The tattoo artist will provide tattoo aftercare instructions. Aftercare usually involves keeping the area clean and applying antibacterial ointment several times a day for a few days.

Before and after pictures

Does a breast tattoo hurt?

How much a nipple tattoo hurts, if at all, varies from person to person. Everyone is different.

However, breast numbness after a mastectomy is common, so most people feel little to no pain when getting a nipple tattoo after a mastectomy.

Women with implants also experience less sensation, even if they have a skin-sparing or nipple-sparing mastectomy.

Nipple tattoo cost

One nipple tattoo generally costs around $350. Most artists appear to offer a slightly lower rate per nipple if you’re having both tattooed.

However, the cost of nipple tattoos varies among artists and aestheticians. Location is also a factor.

Other than buying antibiotic ointment, there shouldn’t be any other expenses outside of the tattoo. No downtime is required, so you won’t need to take time off work for recovery.

Nipple tattoos are covered by some insurance plans if you meet certain criteria. A tattoo artist can provide you with a receipt that you can then submit to your insurance company.

Unless you have your tattoo done by a healthcare professional, directly billing the insurance company isn’t possible.

Insurance plans, coverage, and criteria for coverage vary among providers, so you’ll need to check with yours.

Nipple reconstruction surgery is a procedure that uses skin from other parts of the body to form a new nipple. Some people feel it results in a more natural look. Others would rather not undergo another surgical procedure.

Nipple reconstruction is typically done several months after a mastectomy, depending on how fast you heal and whether or not you need radiation.

Here’s what to expect throughout the process.

Finding a plastic surgeon

Many plastic surgeons who regularly perform breast reconstruction surgery also do nipple reconstruction. So you may decide to have the procedure done by the same surgeon you’ve already been working with.

However, some surgeons may be more specialized in nipple reconstruction compared to others. It’s OK to search for someone who has a track record of getting good results.

Before you agree to the procedure, it’s a good idea to ask what type of technique they use and request example before and after photos of their work. Be sure to also discuss how big you want the nipple to be.

Nipple reconstruction techniques

Three main techniques are used for nipple reconstruction:

• Using surrounding skin: The surgeon makes small incisions to shape skin in the area into a new nipple.
• Using a skin graft: This involves taking skin from another part of the body (like a healed mastectomy scar or loose skin in other areas) to create the new nipple.
• Using nipple sharing: This is something that can be done if you had a mastectomy on only one breast. The surgeon uses a portion of the remaining nipple to reconstruct a new nipple on the affected breast.

No matter what technique is used, the reconstructed nipple may start out larger than desired at first. This is done intentionally, as the reconstructed nipple will flatten over time.

The day of

Nipple reconstruction is an outpatient procedure that typically doesn’t require an overnight stay. Your surgeon will give you a list of instructions for how to prepare, depending on the type of procedure you’re having.

The surgeon will start by marking your breast plus any potential skin graft location to show you where incisions will be made.

Most people only need local anesthesia for this procedure, which means you’ll be awake throughout. The surgeon will use a needle to inject the numbing medication into the areas involved.

However, if general anesthesia is needed, you’ll be given the medication intravenously, and you won’t be awake.

The procedure typically lasts 15 minutes to an hour.

Aftercare

After the procedure, your surgeon will likely apply antibacterial ointment to the area and keep it covered with a nipple shield or bandage. This protective covering should usually stay on for anywhere from 3 to 7 days.

If you only had local anesthesia, you can go home soon after. If you had general anesthesia, you’ll need to be monitored as you wake.

It’s important to follow the specific instructions your doctor provides on how to care for the bandage and stitches, as well as how long you need to wait before showering.

After 4 to 6 months, nipple tattooing can also be done to enhance the results of nipple reconstruction.

Before and after pictures

Does nipple reconstruction surgery hurt?

How much a nipple reconstruction surgery hurts, if at all, varies from person to person.

Mastectomy significantly reduces sensation in the breasts, as nerves are cut during the surgery. If you have nipple reconstruction, your new nipple likely won’t have any sensation.

However, if a skin graft was used for the procedure, the area of the graft may be painful and tender for 1 to 2 weeks. Ask your doctor for tips to help alleviate these symptoms.

Nipple reconstruction surgery risks

Nipple reconstruction does come with certain risks, such as:

• Breakdown of tissue: The tissue used to reconstruct the nipple may die and need to be removed.
• Disappointment: You may be unhappy with the final positioning of the reconstructed nipple after it heals or how flattened it may become over time.

However, in many cases, if the nipple hasn’t been tattooed, you can opt for another surgery to improve the results.

Nipple reconstruction costs

Most insurance companies cover both breast reconstruction and nipple reconstruction.

However, you may need to work closely with your health insurance company and your surgeon to ensure related claims are approved. Be sure to ask about any out-of-pocket costs, which can vary based on your exact coverage.

If nipple reconstruction or tattoos don’t appeal to you, or you’re not ready to try it yet, prosthetic nipples are another option. These are temporary nipples that you can put on or take off as you wish.

Prosthetic nipples come in a variety of colors and styles to help match your natural nipples.

Types of prosthetic nipples

There are two main categories of prosthetic nipples:

• Stick-ons: These are typically made from soft silicone and come with an adhesive so you can put them on or take them off as you wish.
• Temporary tattoos: These can be applied directly to the skin with a wet cloth and removed with rubbing alcohol, but otherwise last up to 2 weeks.

Cost of prosthetic nipples

The exact cost of prosthetic nipples can vary based on your insurance coverage. While most insurance companies do cover the cost, you may have to pay upfront and submit a claim for reimbursement. Your plan may also require a prescription or letter from your doctor stating the need for the prosthetics.

If you’re interested in trying prosthetic nipples, talk with your doctor about next steps.

Various options are available after a mastectomy to give breast cancer survivors the option to have a realistic-looking nipple. Talk through your options with your doctor to help determine which option might suit you best.