Editor’s Note: Vinnie Myers is a tattoo artist who specializes in 3-dimensional nipple tattoos for women who have had mastectomy and/or reconstruction — you may have seen some of his blogs right here. I recently spoke with Vinnie to get answers to some of the questions he’s most frequently asked in the comments.
— Caroline Durham, content manager of Breastcancer.org

When can I get nipple tattoos done?

Timing of nipple tattooing depends on what type of surgery you had and the location of the incisions/scars. If the mastectomy scar isn’t across the middle of the breast, across the area where the nipple would be, you should wait until at least 12 weeks post-surgery. If there is a mastectomy scar across where your nipple would be, or if you’ve had nipple reconstruction, you should wait until a minimum of 20 weeks (5 months) post-surgery. Consult with your tattoo artist to make sure your skin is healed enough to be tattooed — someone who has experience with nipple tattooing should be able to tell if the skin is ready (Vinnie has found that 5 months post-surgery is the soonest healed skin should be tattooed). If the skin isn’t ready, the tattoos take longer to heal and give poorer results. In general, the longer you wait, the better your results.

Is it possible to tattoo a reconstructed nipple?

It’s easier to do a tattoo without a reconstructed nipple. Tattoo artists pull the skin tight in order to deposit the pigment under the skin correctly; trying to tattoo a reconstructed nipple is like trying to pop a half-deflated balloon — the needle has a harder time penetrating the surface. On a reconstructed nipple, less pigment makes it into the skin, so the color won’t be as dark. (Plus, tattooing a reconstructed nipple isn’t really 3-D tattooing, it’s just regular tattooing!)

In cases of nipple reconstruction where cartilage is used either from yourself or a cadaver, the skin can sometimes be extra thin over the cartilage. It can be damaging to tattoo that skin, causing tears or causing the cartilage to break through.

If you have implant-only reconstruction, is there any risk for the tattoo needle accidentally puncturing the implant?

The risk of puncturing an implant is extremely low, but it is technically possible (Vinnie has only turned away a handful of women in his many years of nipple tattooing). If your surgeon was very aggressive and removed all fat under the skin, and the skin is extremely tight over the implant without muscle or much dermal matrix product over the implant, the skin can be very thin in parts. Also, if a saline implant has a port in front, the port can rub the skin from the inside and cause thinning. You may know by feel that the skin is thin, or your doctor may have told you (you can always ask). Tattooing goes about 2 millimeters into the skin, so if your doctor estimates that the skin is 4 millimeters thick or less, tattooing could damage the skin or implant.

Can you correct a tattoo done in the plastic surgeon’s office?

It’s easy to tattoo over an existing tattoo that’s too light — going darker is always easier than going lighter. If your existing tattoo is too dark, it is very occasionally possible to lighten it, but it depends on the skill of the tattoo artist and will take multiple sessions. A layer of light pigment will have to be deposited over the existing tattoo, and that will have to heal before re-tattooing the nipple.

What’s the difference between inks used in the doctor’s office and tattoo shops?

Doctors use a vegetable-based ink to do their tattoos. The pigment particles are smaller and not as concentrated, so the body doesn’t retain them as well. Tattoo ink pigments are heavy metal-based and the particles are larger and much more concentrated. Are you concerned about possibly needing an MRI in the future? It is a myth that an MRI will cause tattoo ink to be ripped out of your skin. Newer tattoos done in good tattoo shops will not cause any reaction (there have been anecdotal reports of some redness or burning, but it is extremely rare and possibly psychosomatic!).

Will getting a nipple tattoo hurt?

Getting a nipple tattoo done should hurt no more than a tattoo on regular skin, if that much. After mastectomy and/or reconstruction, there are likely only surface nerves left in the breast skin, so you will feel something. Women report feeling anything from pressure and vibrations to more sharp, acute (“typical” tattoo) pain. It’s all about expectations — if you don’t expect it to hurt, you might be unprepared for how much you feel. However, if you expect it will be very painful, you should be pleasantly surprised!

How much can I expect one or two nipple tattoos to cost?

Vinnie charges about $400 for one tattoo (unilateral) and $600 for two tattoos (bilateral), touch-ups included. Two tattoos shouldn’t cost more than $1,000, and touch-ups should be included. He’s heard of artists charging thousands of dollars for nipple tattoos but feels that’s outrageously high.

How do I find a tattoo artist to do my tattoos?

It’s possible that more tattoo artists than you’d expect have done nipple tattoos after mastectomy and/or reconstruction for family or friends. However, it’s also possible that some artists might not feel comfortable doing nipple tattoos, probably because of concerns about tattooing compromised skin. Finding a tattoo artist will take some homework and/or legwork: ask people you know for recommendations, or visit some tattoo shops. Look for a clean shop with a pleasant atmosphere and friendly, compassionate staff and artists. It might feel a little uncomfortable to walk into a tattoo shop and ask about nipple tattoos, but that’s really the only way to find out if the shop and artist are right for you.

Ask the artist:

• “What sterile practices do you follow? Do you spore-test the autoclaves?” Autoclaves are devices that use heat and steam pressure to sterilize equipment. Spore-testing means a strip of paper with a certain kind of bacteria on it is run through the autoclave and sent to a testing facility to make sure the autoclave has killed the bacteria. Any good-quality tattoo shop will be very mindful of sterile practices.
• “May I see your portfolio?” Ask to see the artist’s original artwork.
• “Do you have a private room for tattooing?” Many tattoo shops don’t; they do all of their tattooing in the main area of the shop.

Do I need a consultation with the tattoo artist ahead of time?

A visual consultation ahead of time can help the artist confirm that your skin has healed enough. Being able to tell if skin is ready is a skill learned by the tattoo artist over time; Vinnie recommends waiting at least 5 months if there is a scar where you’ll be tattooed. If your skin is ready, you can expect to get your tattoo then and there!

How long will it take to create the tattoo?

Timing will depend on how much experience the tattoo artist has with 3-D nipple tattoos and whether you’re getting one done or both. It can actually take longer to do one nipple tattoo, since that requires matching color, location, and appearance to the natural nipple. Two to 2.5 hours is about average for one tattoo, from walking in the door to walking out. With an experienced artist and nicely healed skin, the tattoo(s) might take as little as 1.5 hours. It might take longer than 2.5 hours for a tattoo artist with less experience in nipple tattooing — mixing the colors can take some time, as it’s important for the colors to look natural.

How long will the tattoo(s) take to heal?

Tattoos typically take about 5 days to heal. However, skin that is thinner or that has less blood supply can take longer — up to a few weeks. Following the artist’s instructions for care will help your tattoo heal faster and better.

How does the color of the tattoo change over time?

When they’re first done, tattoos will be darker (more intense) and redder since the skin has been damaged. As they heal, the tattoo(s) will lighten slightly. Well-done tattoos shouldn’t change color after 1 or 2 months. If you’ve seen standard tattoos that are a number of years old, you may have noticed that they look a little softer and more diffuse — however, this might make nipple tattoos look more natural!

If your tattoos took longer to heal, had problems healing, or the skin was damaged during the tattooing process, the final color may be affected.

 

Vinnie’s shop, Little Vinnie’s Tattoos, is in Finksburg, MD, not too far from Baltimore. He also tattoos in New Orleans one week per month at the Center for Restorative Breast Surgery. You can call his shop for more information on appointments in Maryland at 410-876-4638 or the Center for Restorative Breast Surgery for appointments in New Orleans at 504-899-2800.