Nipple-Areola Tattooing, Completing The Transformation

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Nipple-Areola Tattooing, Completing The Transformation
August 11
12:46 2016

While breast and nipple reconstruction can already be life-changing, there’s one last step that will make the transformation complete. Although it’s an optional decision to make, re-pigmentation of the areola can help enhance a breast by adding semi-permanent colour to the areas affected by cancer or trauma, thereby creating a more realistic appearance. Surgical nipple reconstruction can also be skipped altogether and instead a tattooed simulation can be performed, where the illusion of a protruding nipple can be achieved.

Kyla Gutsche, founder of Cosmetic Transformations in Peterborough, Ontario, is well known for her exceptional work in both areola re-pigmentation and nipple simulation.

“That area is like a face without eyes until the tattoos have been added,” said Gutsche. “Even if someone opts for a surgically reconstructed nipple, it remains a white, scarred surface until it is tattooed.”

Gutsche has developed what’s called the Titian Wash ™ technique, where different colours are implanted into the dermis at varying layers to create a more luminous effect than standard approaches. Gutsche believes that while nipple simulation does not give the same projection as the surgical option, it can prove to be the better option for those wanting to avoid the added risks of surgery.

Nipple-Areola Tattooing, Completing The Transformation

Nipple-Areola Tattooing, Completing The Transformation

“The future is towards three-dimensional nipple tattoos, because you don’t have the patient being opened up for additional surgery; in addition, symmetry can be guaranteed and a good aesthetic result obtained when the surface is not scarred from a surgical reconstruction,” said Gutsche.

The remarkable part of nipple-areola tattooing is its ability to blend in with the client’s skin tone, hiding the fact that it’s any sort of tattoo. If a unilateral breast reconstruction was performed, only one breast will require tattooing. In this case, Gutsche matches the new nipple to the natural nipple that is on the other breast. If a client undergoes a bilateral breast reconstruction, then they will have a say in how they would like their new nipples and areolas to look. More often than not, the client will opt into reproducing the same nipples they had before undergoing breast cancer.

“I think when something is taken from you, you look at it in a whole new way,” explained Gutsche. “Some of my clients have said, ‘Before, I used to think my areolas were too small or too dark, or too big, and now I miss them because they were taken from me.’ In these situations I have to reconstruct as closely as possible what they had before by drawing upon their memory.”

According to Ontario Ministry of Health and Long-term Care, the procedure is currently covered in Ontario by OHIP only when performed by a physician. Gutsche mentioned that not many surgeons perform the service.

Nipple-Areola Tattooing, Completing The Transformation

Nipple-Areola Tattooing, Completing The Transformation

She emphasized that anyone performing micropigmentation, or restorative tattooing, should have undergone a lengthy apprenticeship in order to develop the required skill, and must be knowledgeable in dealing with reconstructed skin and scarring.

“Often the skin is compromised on a breast cancer survivor. The skin is not the same as on another part of the body,” said Gutsche. “Often too, breast cancer survivors have undergone radiation, and so it is imperative to know how to deal with radiated skin and the complications that can result.”

According to Gutsche, the tattooist especially must be able to handle reconstructed nipples, since they are delicate and can possibly collapse too soon if dealt with incorrectly. Risks involved with nipple-areola tattooing are the same as with any other tattooing, mainly consisting of bloodborne pathogen illnesses, including hepatitis B, hepatitis C, HIV, along with infections such as MRCA (Methicillin-resistant Staphylococcus aureus) and E. coli. There is also the possibility of an allergic reaction to the pigment, making test patches an important part of the treatment.

Anaesthetic is not used as minimal discomfort is felt, and according to Gutsche, it “can interfere with retention of the treatment.” If a woman had undergone nipple reconstruction with her plastic surgeon, she must wait eight to 12 months before undergoing tattooing. On the other hand, if just a breast reconstruction was done and the woman would like three-dimensional nipple tattooing, she only needs to wait four months post-op “to ensure that the mounds have settled and a symmetrical result with the tattooing can be achieved.”

Once the treatment is complete, it will take a few weeks before the final result is seen. Gutsche recommends for the tattoo to be kept clean both morning and night, and moisturized. There are also three phases that the tattoo will go through.

“A very thin patch will form, and when it peels, it reveals a lighter effect because that new skin that develops is a bit thicker than it normally would be. Over the next few weeks, the area will become more translucent as the protective new skin sheds and you’ll see the pigment more clearly,” said Gutsche.

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