3-D Tattooing for Nipple and Areola Reconstruction

Published on December 27, 2017

Breast reconstruction following surgery for breast cancer has come a long way since I started doing it some thirty years ago.

Mastectomy is much less common now. Lumpectomy and radiation are most often the chosen paths. Thus the nipple and areola survive. But even now, when mastectomy is elected as the preferred approach, the nipple and areola as well as the skin envelope can be preserved. But there are still some cases where not only the entire breast (mastectomy) but the nipple and areola must be sacrificed.

How does that loss get reconstructed? Typically, the areola gets replaced by a medical tattoo. Straightforward. What about the nipple? More difficult. Small local flaps of skin and fat can be used, but the results are often poor in the long term, especially in women of normal weight. There are also prosthetic “nipples” that can be inserted under the skin. But the cost is high and the complication rate is not insignificant.

Enter 3-D tattooing. This technique, akin to 3-D visuals, allows the nipple to be seen as distinct and on another plane from the areola. I have seen the results and they are remarkable. Of course this is only a visual phenomenon; touching the surface will reveal it for what it is. But fooling the eye is a huge part of the battle!