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. 2020 May 30:55:305-307.
doi: 10.1016/j.amsu.2020.05.041. eCollection 2020 Jul.

Tattooing of the nipple-areola complex: What not to do. A case series

Marta Starnoni  1 , Alessio Baccarani  1 , Massimo Pinelli  1 , Antonio Pedone  1 , Giorgio De Santis  1
Affiliations

Tattooing of the nipple-areola complex: What not to do. A case series

Marta Starnoni et al. Ann Med Surg (Lond). .

Abstract

Introduction: Reconstruction of the nipple areola complex (NAC) is the final and easier step of breast reconstruction. However, surgeons, especially if trainees, typically have not developed tattoo skills during their training. The aim of this report is to share advice developed in our clinical practice that would minimize patient complaints and complications while performing NAC tattoos.

Methods: From January 2016 to May 2018, reconstruction of NAC was performed in 48 consecutive patients. Nipple reconstruction was performed initially using skin flaps and this was followed three to eight months later by NAC tattooing. We analyzed medical reports at 12 months follow-up where we usually record patient satisfaction (very satisfied, satisfied, dissatisfied) and every patient's complaint or complication.

Results: Thirty-two patients (67%) were very satisfied of NAC tattooing, twelve patients (25%) satisfied, while four patients (8%) dissatisfied. Patients complained for not having involved in choosing color, areas without sufficient pigment, extreme darkness of the tattooed NAC and artificial look.

Conclusion: Tattooing is a simple and safe procedure, with a high satisfaction rate. Based on our experience, despite some technical aspects have to be considered, it is a procedure that can be safely performed by plastic surgical trainees.

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Conflict of interest statement

No conflict of interest.

Figures

Fig. 1
Fig. 1
The tattoo was performed three months after the nipple reconstruction. The difficulty in healing was due to the thinness of skin. Complete healing is shown in Fig. 2.
Fig. 2
Fig. 2
The right reconstructed NAC has a different color compared with the natural contralateral one, because color has not correctly been mixed. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
Fig. 3
Fig. 3
In this bilateral breast reconstruction there isn't uniform density of NACs pigmentation and a further correction is needed.
See this image and copyright information in PMC

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