Areola Repigmentation

Areola repigmentation, or nipple tattooing, is often the final step after breast reconstruction. Also known as micropigmentation or "permanent make-up," it can also be done to conceal a scar or cosmetically enhance your nipples.

Preparing for Areola Repigmentation

Before undergoing areola repigmentation you will need to discuss your goals and concerns with your provider. This is the time to bring up nipple color and size. Some technicians will perform a spot color test to make sure the color matches your skin tone and meets your aesthetic goals.

You should avoid alcohol; aspirin, ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs); and certain dietary supplements like vitamin E for at least one week before the procedure. These can increase your risk of bleeding. Ask the provider for a full list of instructions about what you should, and should not, do before your surgery.

The Areola Repigmentation Procedure

Areola repigmentation involves implanting hypoallergenic pigments (color) into the very top layers of your skin with a tattoo gun or pen.

To begin, the technician will inspect your skin to make sure it is healthy enough for areola repigmentation. Next, he or she will clean the area with alcohol and/or spray it with an antiseptic solution. The technician will then transfer a stencil of the tattoo or draw the desired shape onto your skin. Some providers may use topical numbing cream or another type of anesthesia.

The tattoos are applied with a tattoo gun or pen. These devices have one to 14 needles attached to them to implant the colors. This "needle bar" moves up and down very quickly. The speed and power of the tattoo gun or pen is controlled by a foot switch or pedal.

The technician uses a single needle (or micro-needle) to create a very delicate line. Then, a row of four to 36 needles is used for shading and for the denser areas of your nipple. In general, the areola repigmentation process takes about 45 minutes to perform. You may need a touch-up appointment down the road.

Areola Repigmentation Recovery and Results

Areola repigmentation can be painful. The level of pain varies from person to person. It also depends on the tattoo area. You may feel tender and sore afterward. It will take seven to 10 days for the tattoo to heal.

After the procedure is completed, an antibiotic cream is applied over the tattoo. Your provider will also give you other instructions for your recovery, including:

  • Not washing the area more than twice a day
  • Using mild soap and water
  • Appling antibiotic cream as needed
  • Leaving the area exposed to the air
  • Keeping the area moist until the healing is complete 
  • Not picking at any scabs or flakes

There are some risks, including scarring and infection. Areola repigmentation is considered a permanent procedure, although there are tattoo removal methods available such as laser tattoo removal.

Buyer Beware: Choosing an Areola Repigmentation Provider

Licensing requirements for micropigmentation treatment providers vary by state. For example, there is no licensing required to perform micropigmentation in California. Other states require that the treatment provider have some level of training and certification. Some technicians may earn a certificate after a weekend course in micropigmentation. Ask to see their certificates of training, and their tattoo license, if one is required by your state.

Make sure to ask:

  • How long have you been applying micropigmentation? 
  • How many procedures have you performed?
  • Do you have experience with scars? (This is important if you are having scar tissue from breast augmentation repigmented.)

Also ask to see photographs of the technician's work before making your decision. Your breast surgeon may have some recommendations about reputable and skilled providers.

Areola Repigmentation Cost

Areola repigmentation cost can range from $200 to $800. Ask if the price of touch-ups is included in the cost. Insurance will cover the cost of areola repigmentation if it is considered reconstructive (e.g., following breast cancer surgery).

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    Joshua A. Greenwald, MD, FACS

    Greenwald Plastic Surgery
    166 5th Ave
    Second Floor
    New York City, NY 10010
    (914) 421-0113
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    Joshua A. Greenwald, MD, FACS

    Greenwald Plastic Surgery
    10 Chester Avenue
    Second Floor
    White Plains, NY 10601
    (914) 421-0113
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    Sandra Margoles

    Sandra Margoles MD, FACS
    2 1/2 Dearfield Dr
    Greenwich, CT 06831
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