Areola Micro Pigmentation following Breast Reconstruction Surgery

Patient Experience

  • Reference Number: HEY-120/2023
  • Departments: Breast Services
  • Last Updated: 31 October 2023


This leaflet has been produced to give you general information.  Most of your questions should have been answered by this leaflet.  It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is areola micro pigmentation?

Areola micro pigmentation is a medical tattoo in which pigment (colour) is implanted into the skin of your breast reconstruction to re-create the colour and shape of the nipple-areola complex. The aim of this procedure is to create an areola that is as realistic as possible but will not match 100% to the opposite nipple/areola.

The pigment is applied using a pen-like device loaded with a sterile cartridge (containing needles). The needles move up and down at a rapid rate to penetrate the outer and inner layers of skin in order to implant the pigment.  Pigments are comprised of iron oxide, titanium oxide, alcohol, water and glycerin. 

Can there be any complications or risks?

Some of the risks or complications are listed below:

  • Allergy to pigments/and or topical anaesthetic
  • Infection
  • Areola micro pigmentation will not match 100% to opposite areola
  •  Fading of the colour over time
  •  Colour spreading from the original position
  •  Uneven pigment colour over the area
  •  Scarring

All potential complications or risks will be fully discussed with you by a member of the healthcare team. Please ask if you need clarification.

How do I prepare for the procedure?

Please read this information leaflet. Share the information it contains with your partner and family (if you wish) so that they can be of help and support.

Upon Arrival

You will be met by a practitioner who has been specially trained in the art of nipple/areola micro-pigmentation (medical tattooing). Your appointment will last approximately 1.5-2 hrs.

Before the procedure

The procedure will be explained to you and there will be plenty of opportunity to ask questions.

Medical photographs will be taken before and after your procedure(s) and kept digitally with your clinical records, providing a useful tool in documenting progress.

Your practitioner will go through the contraindications before you sign the consent form and a topical anesthetic cream is applied to the area(s) to be tattooed. This takes approximately 45 minutes to work (most patients feel no or very little sensation when being tattooed, just a slight buzzing against the skin).

During the procedure

In the next stage your practitioner will match up the colour of your existing nipple/areola (pigments are mixed together to get as close a match as possible) or help you choose a suitable shade for your skin tone if both breasts are being tattooed. The pigments used will be recorded in your clinical notes for future reference and treatments.

After removing the topical anaesthetic your practitioner will measure and map out as precisely as possible to the existing nipple/areola or create both nipples/areolas if both breasts are being tattooed. You will have chance to look at this in the mirror and check you are happy with the size, shape and position before tattooing begins.

Each nipple/areola takes approximately 20 minutes to complete.

Your tattoo(s) will appear darker immediately after implantation and you should expect to see a fade of up to 40% in the following week. The pigment takes a minimum of 4 weeks to settle fully in the skin. 

All equipment used is sterile and disposable needles are used for each individual procedure.  A small dressing or clear film will be applied to cover the area and you will be asked to remove this after 24 hours.

You will be given written instructions on how to care for your tattoo along with contact numbers.

What happens afterwards?

You will be able to drive yourself home and be able to resume normal activities immediately after the procedure. 

Important Reminders:

  • DO NOT rub, pick or scratch the treated area.
  • Let any scabbing or dry skin naturally exfoliate away. Picking can cause scarring or loss of colour
  • Once dressing/film are removed DO NOT swim or soak the tattoo in water, such as swimming pools/hot tubs for 2 weeks as chlorine may fade your tattoo.
  • DO NOT tan/expose the area to direct sunlight for at least 2 weeks. After this always apply a high factor sunscreen over the area as prolonged UV exposure will fade a tattoo.
  • Avoid hot, steamy showers for 2 weeks, keep temperature moderate and try to keep your back to shower until the end when you can wash the tattoo.

Remember, with the proper aftercare routine you will have much better results with your micro-pigmentation procedure

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Micro-Pigmentation Practitioner on (01482) 623744/623085 or Breast Care Nurse Specialist (01482) 622013

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.

QR code to open leaflet