3-D Nipple Tattoos Provide Aesthetic Benefits, Study Says

The tattoos can provide an alternative to nipple reconstruction.

From 2006 to 2013, Eric Halvorson, a board-certified plastic surgeon now at Brigham and Women’s Hospital, was very busy doing post-mastectomy breast reconstruction at UNC Chapel Hill in North Carolina. And when it came to nipple reconstruction, an elective procedure usually done three to four months after the initial reconstructive surgery, if a patient would choose to go the tattoo-only route, Halvorson and his team would perform a standard medical tattoo.

“The standard technique for medical tattoo was a light outer circle for the areola, and for the nipple, a dark circle in the middle,” Halvorson says. “Some plastic surgeons do it themselves, or sometimes a nurse or PA will do the procedure. We were generally pleased with these results. But then my nurse, Misti West, came across a guy in Maryland, and he was making tattoo-only nipples that looked better than anything we could do surgically. When you looked at a photograph, you couldn’t even tell that it wasn’t a real nipple.”

Halvorson says that the artist, Vinnie Myers, was doing the exact opposite of what he and his team were doing. The nipple was lighter than the areola, with a darker rim around the areola, which, in the end, was a 3-D result. “The basic artistic principle of creating depth, shadow, and projection on a 2-D surface is that if you want things to stick out, it should be light. Our old way of tattooing was an artistic blunder,” he says.

That’s why Halvorson and his team published a report in the May issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons, that outlines, in detail, that when it comes to women undergoing nipple reconstruction, professional tattoo artists can achieve “aesthetically superior” results by creating realistic 3-D tattoos of the nipple and surrounding areola. Halvorson says that these results (and the equipment, needles, and inks used) are far superior to traditional medical tattooing.

Myers, who was a co-author of the report, has developed a technique of creating realistic-looking 3-D tattoos that uses color to create a more lifelike appearance, “shadow effects” to create the illusion of a projecting nipple, a more realistic-looking areola, and even the small Montgomery glands surrounding the nipple.

“We need better devices and better dyes to achieve a result that is similar to a professional tattoo artist,” Halvorson says. “But, it is a different type of patient population, and there may be insurance reimbursement issues for the tattoo artists. Plus, a tattoo parlor may not be comfortable for a woman who is going in for this kind of procedure.”

Halvorson says that he is trying to get Myers (who, according to his website, accepts insurance) to come up to Boston to teach his staff, because while there are a couple of people in the Boston area who do this procedure outside of a medical setting, he says he’s never seen results as amazing as what Myers can do. Halvorson and his team are interested in talking to Boston-area tattoo artists who may be interested in getting involved.

“It would be great if there were more crosstalk between the industries,” Halvorson says. “We want the best result for our patients, and breast reconstruction is an aesthetic procedure. Ideally, I would like to incorporate techniques used in the professional industry into our hospital practice. The current state of medical tattooing is clearly inferior.”