Our discussion boards have been abuzz recently about the nipple micro pigmentation (tattoo) procedure. Kimberly Kay, PA-C of the Center for Natural Breast Reconstruction(opens in a new tab) provides this comprehensive overview and answers your questions.


The ultimate goal of the reconstructive surgeon is not only to restore the three dimensional breast mound but also to recreate the nipple areola complex.  Some women choose not to undergo nipple/areola reconstruction, it’s a personal choice.

Micro pigmentation (tattoo) is used to re-create the color of the areola and nipple and is often the final step in the breast reconstruction process.   A variety of colors and color combinations are used to create a dimensional or projected look.  Here is a basic idea of what to expect:

1. The entire nipple/areola is shaded with the color you choose.

2. Then the original color is darkened with a slightly darker shade and a special needle is used to create the bumpy “Montgomery Gland” look of a natural breast. 

3. Finally, a little darker shade is used to give the nipple a projected look.

It sounds like a pretty straightforward procedure, right?  Given that the shades you can choose from are numerous, the process itself takes may require some needle changes & stroke techniques to be precise; we like for you to plan to spend at least an hour or two with us on your tattoo procedure day.

Nipple Tattoo Procedure

Be aware, the process is not always painless, so it’s beneficial that the procedure be done in a medical office setting if you think you may require a clinician to administer a local anesthetic prior to the procedure.   The addition of the local anesthetic Lidocaine with Epinephrine has the benefit of reducing bleeding at the tattoo site thus keeping more of the pigment from leaving the tissue.   And the procedure is not without risk.  You should be provided with an informed consent document prior to undertaking this procedure that outlines contraindications and possible complications (i.e. – allergic reaction, contact dermatitis, etc).

Nipple Tattoo 2

Our nurses and PA’s at The Center for Natural Breast Reconstructio(opens in a new tab)n receive specialized training through the PMT/Permark Training School Midwest in the Art of Nipple Areola Micro pigmentation.  Their instructor, Kathy Jones, is the Director of the Permark Training School and a board certified plastic surgical nurse with close to 20 years experience in the plastic surgery field.   Since, 1994 she has taught micro pigmentation to hundreds of practitioners in the United States and abroad and is a popular micro pigmentation lecturer.

The tattooing procedure is billed to your insurance company as a part of the reconstruction process since it is performed in our medical facility under the direction of our surgeons.  Touch up procedures may be required as some tattoos tend to fade with time, more so on scarred tissue.  If you have additional questions you’d like answered about the “nipple tattoo” process….please send them in(opens in a new tab). Be sure to check out our gallery for more photos! (opens in a new tab)

Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!(opens in a new tab)