tattooed nipples after breast cancer

Nipple Tattooing Provides the Finishing Touch Following Breast Cancer Reconstruction | Fox Chase Cancer Center - Philadelphia, PAnipple reconstruction surgery and nipple tattoos If one or both of your nipples were removed when you had a mastectomy, in most cases you can choose to have surgery, tattoo, or both to recreate the nipple and areola (the dark zone around the nipple). Some people find that having their reconstructed or tattooed nipples is an important final step in the process of breast reconstruction. Not others. The choice is totally yours, and you can take your time to decide. Plastic surgeons usually recommend waiting at least 4 months after breast reconstruction surgery to have nipple reconstruction or nipple tattoos. This will give your breasts time to heal and settle in a final position. It is also better to wait until you are completely satisfied with the rest of your reconstruction. Rarely, some surgeons may offer the option of rebuilding the nipple as part of the breast reconstruction surgery (rather than as a separate surgery). This is usually not recommended because it can lead to a bad position of new nipples. Comparison of options: The nipple reconstruction surgery is usually an outpatient procedure that uses the skin from the breast area where the nipple will be placed to form a new nipple. Later, the reconstructed nipple can be tattooed to add color and create the areola. The main advantage that your nipple is reconstructed with surgery is that it will be projected from your breast. Some women feel that this creates a more natural aspect. The disadvantages are that it involves surgery at a time in the reconstruction process when you may not feel that you have more surgery, and carries some minor risks. In addition, a reconstructed nipple will flatten and lose most of its projection over time. The nipple reconstruction can give you a good cosmetic result, but a reconstructed nipple will not be seen and will feel like its original nipple. It is also important to know that most women lose feeling in their area of breast after mastectomy and breast reconstruction, so it is likely that they do not have a feeling in their reconstructed nipple either. 3D nipple tattoos are real tattoos, applied with needles that insert pigment into the skin. An experienced nipple tattoo artist can create an incredibly realistic picture of a nipple that seems to have a physical dimension but is really flat to the touch. In recent years, a growing number of people have opted for 3D nipple tattoos instead of nipple reconstruction surgery. In addition, plastic surgeons usually recommend 3D nipple tattoos instead of nipple reconstruction surgery. You can also make the nipple tattoo to improve the results of the nipple reconstruction surgery. Some of the advantages of choosing the tattoo are: Although some women may consider it a disadvantage that a 3D nipple tattoo has no physical dimension, others say they are happy that they can jump using a bra and that their nipples are not shown through their clothes. Women who have had breast reconstruction with an implant or a flap of tissue are candidates for nipple reconstruction or nipple tattoos. But you can't be a candidate if: Prosthetic nipples are another option. If you can't or don't want to do nipple reconstruction surgery or nipple tattoo or are still deciding, you can always try nipples (prosthetic) or temporary nipple tattoos. Custom prosthesis nipples may look like natural nipples, and you can put them and remove them anytime you want. On this page, you can learn about how to prepare and what to expect if you have nipple reconstruction or nipple tattoo, how to use and where to buy nipples and temporary tattoos, and more. More information about: Breast reconstruction SurgeryFind a plastic surgeon for nipple reconstruction surgery Most plastic surgeons who perform a lot of breast reconstruction surgery have experience with nipple reconstruction. However, plastic surgeons vary in their level of skill and experience when it comes to the procedure. It makes sense to choose a plastic surgeon who has done many nipple reconstruction surgeries and has a history of getting good results. You may decide that your nipple reconstruction surgery performed by the same surgeon who did your other reconstructive procedures or by a different surgeon. Ask the plastic surgeons you are considering for nipple reconstruction questions such as: Flexible reconstruction techniques There are a number of techniques used by plastic surgeons for nipple reconstruction. For example: Whatever the technique used, the surgeon will usually try to create a reconstructed nipple that is larger than the desired final size. This is to compensate the fact that the reconstructed nipple will flatten over time. Before rebuilding your nipple, talk to your plastic surgeon about the size of the nipple you want and make sure you understand how reconstruction surgery will be done. What to expect during and after nipple reconstruction surgery The nipple reconstruction surgery is usually an outpatient surgery, which means it doesn't stay overnight in the hospital. However, some people have a night stay in the hospital if they have nipple reconstruction at the same time as other surgery. Your doctor will give you a list of instructions on how to prepare for surgery. Your surgeon will draw marks on your chest (and in another area of your body if a skin graft is used) to show where the incisions will be made. You'll probably stand while this happens. The nipple reconstruction is often done under local anesthesia. This means that your doctor will use a needle to inject drugs to numb in the area where the reconstructed nipple will be. If you have local anesthesia, you will be awake during the procedure. If your doctor is taking the skin from another place in your body to reconstruct the nipple, that area will be numb with local anesthesia, too. Only a small amount of skin is needed to recreate the nipple. If you and your doctor decide that nipple reconstruction surgery should be performed under general anesthesia, an IV infusion line will be inserted into your hand or arm and will be connected instead. You will be given relaxing medications through line IV. After surgery, a nipple shield (a protective cover formed like a small hat with a wide flat edge) or another protective dressing is recorded on the reconstructed nipple. It can be filled with antibacterial ointment. The duration of the nipple reconstruction surgery may vary from 15 minutes to an hour or so. If you have had local anesthesia, you can go home after the dressing is in place. If you have had general anesthesia, you will be transferred to a recovery room after surgery, where the hospital staff will supervise you. Once you are awake and your doctor has checked your heart rate, body temperature and blood pressure, you will be allowed to go home. Your doctor will give you specific instructions to follow for your recovery, including how to take care of the protective dressing and points. The protective dressing is normally left for about 3 days a week. After you retire, you can shower. Due to the lack of sensation in the breasts after mastectomy, you will probably not feel much pain or tenderness in the nipple area after surgery. If the skin was grafted from another part of the body, it is likely that the area will feel tender or painful for a week or two. Ask your doctor if you can take medications to relieve any pain you may have. It is not discouraged by the initial appearance of your new nipple(s). They can look bigger and more pointed than you expected, red and swollen, with visible incisions. As the nipples heal, they'll start shrinking and look more like you expected. Between 4 to 6 months after nipple reconstruction surgery, you may have tattoos applied to the reconstructed nipple and areola(s) to add color and make them look more realistic, if you wish. (See below for more information on ). Risks of reconstruction surgery Like all surgeries, nipple reconstruction carries some risks. Here are the most common: Disaggregation of tissues: When the tissue used to reconstruct the nipple does not receive enough blood, some of the tissues may die. This breakdown of tissue is called "necrosis. " If necrosis occurs, the plastic surgeon will have to cut the dead tissue. If you have just a small amount of tissue necrosis, for example, if only the nipple tip is affected, then you may only need basic attention from the wound after the dead tissue has been removed. But if the breakdown of the tissue is more extensive, you may need to remove the nipple. In most cases, you can rebuild the nipple again. Bowl: It is common for a reconstructed nipple to lose much of its projection over time. If it bothers you how much your reconstructed nipple has flattened, your surgeon can be able to rebuild the nipple. This will usually involve making small incisions, forming the tissue in the form of a nipple, and securing it with points. The surgeon can also add a rolled piece of acellular dermal matrix material (a substitute for soft tissue made of human or animal skin), or a skin graft, cartilage or fat from another part of the body to help ensure that the nipple is projected from the breast and reduce the risk of being flattened again. Poor positioning: There is a small risk that you may not be happy with the position of the new nipple (s) once they heal. This is more likely to occur if the surgeon performed the nipple reconstruction during breast reconstruction surgery rather than as a separate surgery. In some cases, you may choose to get another surgery to restart the nipple(s) in the breast. The plastic surgeon will make a series of incisions and move the skin of the breast to restart the nipple. The nipple(s) will remain attached to the underlying skin. It is important to know that your plastic surgeon may not be able to move a reconstructed nipple that has already been tattooed. If you had reconstructed a nipple and maintained a natural nipple, and are not symmetrical, it can be easier for your plastic surgeon to move the natural nipple than the reconstructed one. Pay for nipple reconstruction surgery In the United States, your health insurance plan should cover nipple reconstruction if it also covers breast reconstruction. The Women ' s Health and Cancer Rights Act 1998 requires that all group health plans and health insurance companies (including health organizations) pay for mastectomy to also include reconstructive procedures. Medicare generally covers breast reconstruction procedures including nipple reconstruction, while Medicaid coverage may vary from state to state. However, it is not unusual to have some challenges with getting your health insurance to cover nipple reconstruction. The rebuilding of the nipple is normally done and is invoiced separately from its other reconstruction procedures and requires independent insurance authorization. Before nipple reconstruction surgery, work with your health insurance provider and your plastic surgeon's office to find out what you need to do to make your claim approved. You and your plastic surgeon may need to do the case to the insurance company that nipple reconstruction is a medically necessary part of breast reconstruction and not just cosmetics. You will also want to find out exactly what will be covered in advance and what you will need to pay in pocket. More information about . Bowl tattoos A 3D nipple tattoo is a "image" of a nipple and areola in the chest that is flat to the touch but it looks three-dimensional and quite real. 3D nipple and areola tattoos are real, permanent tattoos, applied by a qualified tattoo artist with needles that insert pigment into the skin. Many women choose to get permanent 3D nipple tattoos instead of nipple reconstruction surgery. A nipple tattoo is less invasive than nipple reconstruction, and some people feel that cosmetic results are better. A tattoo may have fine details, shaving and coloring that make it look more realistic than you can do with surgery. For example, a tattoo can create the illusion of the Montgomery glands (small blows that naturally appear in the areola). The tattoo is also used after nipple reconstruction surgery to add color to the new nipple(s), making them look more realistic and create the appearance of areola(s). Ideally, the nipple tattoo should be the last stage of the breast reconstruction process. It should occur at least 4 months after your last breast reconstruction procedure or at least 4 months after nipple reconstruction surgery. The nipple tattoos are usually applied in a session in the office of a plastic surgeon, a hospital or a study of a nipple tattoo artist. If you are thinking of getting a nipple tattoo in the study of a nipple tattoo artist (and not in your plastic surgeon's office), make sure your plastic surgeon has given you the first approval to advance with the nipple tattoo. The color of the tattoo may fade slightly over time, and you may want to get a touchup session at some point. As with nipple reconstruction surgery, you may not be a nipple tattoo candidate if: If you're wondering if you can get nipple tattoos, talk to your plastic surgeon and an experienced nipple tattoo artist about your individual situation. Sometimes you may only have to wait longer — for example, for your breast skin to heal more — until you can get nipple tattoos. Find a qualified nipple tattoo artist The nipple tattoos can be made by the office officials of a plastic surgeon (such as a nurse, medical assistant or plastic surgeon) or by a specialized nipple tattoo artist. In general, you will get the best results with a tattoo artist nipple because they have the most training and experience. Ask your medical team if they can recommend a tattoo artist nipple that has worked with many women who had breast reconstruction. The tattoo artist must be aware, for example, of the factors involved in the skin tattoo that has scars. Always ask to see photos of the work of a nipple tattoo artist who is considering. Small tattoo artists can work outside their own studio and also travel to provide tattoos in offices of plastic surgeons and hospitals in their region and elsewhere. Here are some tattoo artists in the United States who specialize in the nipple and areola tattoo: What to expect during and after nipple tattoo A nipple tattoo appointment may take 1 to 2 hours. During the appointment, the tattoo artist will talk to you about your preferences for nipple and areola size, shape, placement and color. If you still have one of your natural nipples, the tattoo artist will adjust to the color and size of the new nipple. If both nipples were removed during mastectomy, you may want to provide the tattoo artist with a pre-surgery picture of his breasts as a reference point. If you do not have a photo, you can ask your breast or plastic surgeon for one. To help determine the best positioning for nipple tattoos, the tattoo artist can place prosthetic silicone nipples on his breasts. The tattoo artist will also review a pigment palette with you ( rose tones, so, beige, brown and purple) to select colors for the nipple and areola that look natural and complement your skin tone. After mixing the pigment, he or she will temporarily apply a color swatch to your breast skin so you can see how it looks in different lighting and when it moves around. The tattoo artist will also draw marks on his chest to show the location, size and shape of the new nipple and areola. The tattoo usually takes about half an hour or so for nipple. Because the reconstructed chest does not have the same feeling as before mastectomy, tattooing the area is usually not painful. However, some women report experiencing some mild discomfort or pain during the nipple tattoo. The nipple tattoos will be covered with a protective dressing. Ask for instructions on how to take care of the area. It usually takes approximately 7 to 10 days for the area to heal. Avoid chlorinated pools, hot tubs and bathtubs, as well as sun exposure for several weeks after the tattoo application. Pay for tattoos nipple The nipple tattoo price provided by an experienced tattoo artist is typically $350 for a nipple and $600 to $800 for two nipples if you are paying out of pocket. The price can be higher if the tattoo artist is traveling to his area to make tattoos. Some insurance plans cover the nipple tattoo. Medicare often covers nipple tattoo (although it is not necessary to do so under federal law), and Medicaid coverage may vary from state to state. If you get your nipple tattoo in the office or hospital of a plastic surgeon (either from a medical staff member or a visiting tattoo artist), then that facility can usually handle the insurance claim for you. If you get your tattoo in the independent study of a tattoo artist, then you will have to send the claim to your insurance. You can send a receipt from the tattoo artist and a prescription for the tattoo of your plastic surgeon containing the appropriate insurance codes. The tattoo artist can also write a letter to the insurance company on his behalf. You, your plastic surgeon, and your tattoo artist may need to do the written case that nipple tattoo is a medically necessary part of the breast reconstruction process and not just cosmetic. If you don't have insurance coverage and can't pay the full price for a nipple tattoo, some tattoo artists can offer a discount or may have certain days throughout the year when they offer free nipple tattoos. In addition, the non-profit Sharsheret to help cover the cost of nipple tattoo for women in need in New York, New Jersey, Pennsylvania, Florida, Illinois and California. Plastic films and temporary nipple tattoos Some women find sticky nipples (protected) to be a surprisingly good alternative to nipple reconstruction or nipple tattoos. You may want to try prosthesis nipples if you do not want or can not get nipple reconstruction surgery or a nipple tattoo, you are still deciding, or you are waiting to finish other procedures first. The aesthetic nipples are made of soft silicone, and you can put them and remove them whenever you want. They are self-adhesive or come with a special skin adhesive that can keep the nipple in place for several days or more. They look and feel like real nipples and are available in different sizes, colors and projections. Two of the best known brands are: Some insurance companies cover the cost of prosthetic nipples. In most cases, you will have to file the claim to your insurance yourself, with a receipt for prosthetic nipples and a prescription or letter from your doctor indicating that prosthetic nipples are medically necessary. Another option to explore that has the advantage of being cheap: temporary nipple tattoos, like, , and . These apply to the skin using a wet cloth, can last 1 or 2 weeks, and can be removed with scrubbing alcohol. Written by: This page was developed with contributions from the following experts: Sophie Bartsich, M.D., FACS, a private plastic surgeon in New York, NY, a medical assistant professor at the New York-Presbyterian/Weill Cornell Medical Center Paul Bessette, tattoo artist with the team Vinnie Myers in Finksburg, MD, who specializes in 3D nipple and areola tattoo Constance M. Chen, M.D., MPH, FACS, Plastic and Reconstructive Surgeon in Private Practice in New York, NY, Clinical Assistant Professor of Surgery in New York-Presbyterian/Weill Cornell Medical College , plastic surgeon, founding partner of the Breast Restaurativa Surgery Center and St. Charles in New Orleans, LA Ron Israeli, M.D., FACS, plastic surgeon, founder partner of New York Breast Reconstruction and Aesthetic Plastic Surgery in Great Neck, NY, clinical assistant professor at Zucker School of Medicine in Hofstra/Northwell Elisabeth Potter, M.D., a private plastic surgeon in Austin, TX, an affiliate professor in the surgery and perioperative care department of the University of Texas at the Austin Dell Medical School Smita Ramanadham, M.D., FACS, plastic surgeon certified by the board in SR Plastic Surgery in East Brunswick, NJ Mandy Sauler, AAM, tattooist, medical tattoo specialist, owner of the Sauler Institute of Tattooing, Philadelphia PA and New York, NY Can we help you guide you? to improve recommendations Breast self-examination, or regular examination of your breasts on your own, can be an important way to... 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What breast cancer survivors need to know about getting a small tattoo If you have one to treat breast cancer, you have the option to undergo reconstruction of the shape of the removed breast. Breast reconstruction does not usually involve the nipple. And not everyone is a candidate for one, depending on the type, size and location of the cancer. is the final stage of breast reconstruction, and for many, it represents the closing of a difficult chapter. While nipple reconstruction has a, many women are jumping it and getting 3-D nipple tattoos instead. The nipple reconstruction surgery usually occurs several months after a mastectomy, depending on how fast it heals and whether or not it needs. You'll have to wait three months before you can have the tattoo to add color to your new nipples. A The 3-D nipple tattoo offers breast cancer survivors who want nipples a very realistic and less invasive alternative. How soon can a nipple tattoo be made after surgery varies between artists and studies. Most prefer to wait four to six months after their final surgery or reconstruction. Unlike the traditional nipple tattoo made by medical stethists in the office of a plastic surgeon to add color and create a areola around a reconstructed nipple, 3-D tattoos are often used instead of reconstruction. These permanent nipple tattoos are designed and made by tattoo artists in stores and in some specialized medical centers. Some aesthetics are now also offering 3-D nipple tattoos using a semi-permanent technique similar to that used for . The practitioner uses a pigment-coated oscillating tattoo needle. The pigment is inserted into the skin to create the appearance of a nipple. This is what you can expect when you go for a nipple tattoo: First-to-process, you will meet with a tattoo artist for a consultation. During that time, the size, placement and colours of the pigment will be discussed. The tattoo artist will want to see the area in which they will work, to determine the best way to proceed. Then they will create a plan based on their preferences, variables (such as their scar patterns), amount of scar tissue and skin thickness. They will also give you instructions on how to prepare for the procedure. On the day of your procedure, you should get showered, with clean skin. Do not apply humectant or any type of numbness agent. Make sure you have a bra or a camisole with you to help keep your bandages in place. You should also wear a loose and comfortable shirt that opens in front to wear during the procedure. Some shops have robes or dresses where you can change. Then you will be given a consent form to sign, and possibly a health questionnaire to fill in. Then you will be taken to a private room where you will undress and lie in an adjustable bed or chair for your tattoo. The artist will disinfect the skin being tattooed. During the procedureBefore beginning, the artist will again move to place and pigment. Design marks will be made, and once approved, the tattoo will be applied. All the time of the tattoo, including the placement and mixture of pigments, varies among artists. It may take one to three hours, depending on whether one or both breasts are being made. The actual tattoo only takes 15 to 30 minutes per nipple. Aftercare Once the procedure is complete, a bandage on the tattoo will apply. Healing can take a week to 10 days. You can wait a bit of stain or applause. The tattoo artist will provide tattoo instructions. Aftercare usually involves keeping the area clean and applying an antibacterial ointment several times a day for a few days. After a mastectomy is common, so most people feel little to any pain when getting a nipple tattoo after a mastectomy. Mastectomy significantly in the breasts, as nerves are cut during surgery. If you have nipple reconstruction, your new nipple will have no feeling. Women with implants also experience less sensation, even if they have mastectomy or blinking. How much a nipple tattoo hurts, if it varies from person to person. Everybody's different. The cost of nipple tattoos varies between artists and aesthetics. Location is also a factor. Based on Internet research, a tattoo nipple costs. Most artists seem to offer a slightly lower rate per nipple if both are tattooed. Apart from buying an antibiotic ointment, there should be no other expenses outside the tattoo. No downtime is required, so you won't need to take work-free time for recovery. The nipple tattoos are covered by some insurance plans if you meet certain criteria. A tattoo artist can provide you with a receipt you can send to your insurance company. Unless you have your tattoo done by a health professional, billing the insurance company directly is not possible. Insurance plans, coverage and coverage criteria vary among providers, so you need to check with yours. Asking others who have had nipple tattoos on recommendation is a good start. If you do not know anyone personally, you can reach members of a local breast cancer support group or your cancer center. There are a lot of tattoo artists offering nipple tattoos, so making an online search should give you a few options to choose from. You also want to do some tasks to make sure you find someone you're comfortable with and have experience making nipple tattoos. Here are some things to consider before choosing a tattoo artist: Small tattoos after mastectomy give breast cancer survivors the option to have a realistic nipple without having to undergo another surgery. Though flat, these hyperrealistic images give you nipples that appear in 3-D. An experienced tattoo artist can create nipple tattoos with exquisite detail, including different tones, and the appearance of folds and skin that puckers like a natural areola and nipple. Last medical review on July 11, 2019 Read this next set of words

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