• Reference Number: HEY-120/2015
• Departments: Breast Services
• Last Updated: 1 April 2015

Introduction

This leaflet has been produced to give you general information about your procedure.  Most of your questions should have been answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, 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 caring for you.

What is Areola 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.
•  After repeatedly swimming in chlorinated water it may in some cases cause fading.

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

Please come to the reception desk within the Breast Unit, Castle Hill Hospital which you can access via entrance 1.

You will be called into a clinic room where the procedure will take place by the Nurse Practitioner or Specialist Nurse who will perform the micro pigmentation.

Before the procedure

Most women do not have sensation in the area to be treated; however a local anaesthetic ointment will be applied to the skin 30 to 45 minutes before the procedure.

During the procedure

A Specialist Nurse trained in areola micro pigmentation will perform the procedure. You will stand in front of a mirror with the Specialist and discuss the shape to be tattooed and the colours to be used. The colour chosen will appear darker immediately after implantation and you should expect to see a fade of up to 40% in the following week. The colours used will be documented in your case notes for future reference to help with colour selection for subsequent procedures.

The appointment will be for approximately one and a half hours, with the procedure itself taking around 20 minutes.

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

What happens afterwards?

You will be able to drive yourself home and be able to resume normal activities immediately after the procedure but use of cosmetics; excessive perspiration and exposure to the sun on the treated area should be avoided until the area is completely healed.

These instructions must be followed until the tattoo has healed which may take approximately a week:

• You may remove your dressing with clean hands, 24 hours after the procedure.
•  Before showering or bathing, using clean hands, apply a light coat of white petroleum jelly.
•  When showering, please keep your back to the water jets/shower head. Shower gels can be used but not on the treated area. Gently pat the area dry with a clean towel.
•  Do not pick off any scabs which form over the treated area, as this can remove the pigment. Let these fall off naturally (usually within 7 – 10 days).
• The skin may ‘peel’ from the tattooed area.
• You may experience some slight swelling or redness to the area and the skin may feel tight. These symptoms will subside, usually within 1 week, depending on the sensitivity of your skin.
• If you have any problems or concerns you can ring the Breast Unit on (01482) 624079 or (01482) 622679 or your GP.

Until the treated area has healed, please do not swim, use a sauna, a hot tub, or sunbathe. Over exposure to the sun will cause fading and/or colour change.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Nurse Practitioner on (01482) 624079 or Breast Care Nurse Specialist (01482) 622013

This leaflet was produced by Breast Unit Hull University Teaching Hospitals NHS Trust and will be reviewed in April 2018.

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.