breastcancer woman ribbonProfessional tattoo artists can achieve “aesthetically superior” results by creating realistic three-dimensional tattoos of the nipple areola complex (NAC) among women undergoing breast reconstruction, according to a report in the May issue of Plastic and Reconstructive Surgery®.

“The application of ‘3D’ techniques or ‘realism’ in tattoo artistry has significant potential to improve the aesthetic outcomes of reconstructive surgery,” conclude researchers led by Eric G. Halvorson, MD, of Brigham & Women’s Hospital in Boston.

Tattoo artists such as Vinnie Myers of Fredericksburg, Md—one of the authors of the paper—have developed techniques of creating realistic-looking, three-dimensional tattoos. In contrast to the traditional two-dimensional techniques used by plastic surgeons, these artists use color to create a more lifelike appearance—including “shadow effects” to create the illusion of a projecting nipple. Professional tattoo artists also use more sophisticated techniques in terms of machine speed, needle type, and color mixing. Through their technical skills and artistry, these artists can create NAC tattoos that compensate for asymmetries of the reconstructed breast mound. They can also create a more realistic-looking areola—down to the tiny Montgomery glands surrounding the nipple.

Because of the outstanding results achieved by professional artists, Halvorson and colleagues no longer perform NAC tattoos themselves.

“While referring patients to tattoo artists for 3D NAC reconstruction may take some business away from a surgeon’s practice, it is our obligation to offer patients the best results possible,” they write.

The costs of NAC tattooing may be partly reimbursed by insurance. The authors offer tips for finding a local artist who can create NAC tattoos; a listing may be found online at Pink Ink Project.