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Topic: What is a 3D areola tattoo + PS vs. artist?

Forum: Breast Reconstruction — Is it right for you? Discuss timing and various procedures and techniques.

Posted on: Nov 7, 2016 09:33AM

LeftDCISwoman wrote:

Hi all, I could use your help in some terminology here. I just went through a nipple reconstruction (after a UMX and implant) via nipple sharing from my non-cancerous breast. I am very happy with the outcome. I asked the PS about the areola, and he said "we'll tattoo it".

I have read several other articles online about this procedure, and some mention a 3D areola, others just say "tattoo", but most refer to the tattoo as being the areola AND nipple. I do NOT need a nipple tattoo. Can someone clarify this for me?

Also...I was just going to go back the PS, but if I do, I might miss the fact that he might not be able to make it look as real as an "artist" does to match the non-cancer breast. If I do go to an artist, does insurance still cover it? Thanks so much for answering my questions.

Dx 6/14/2013, DCIS, Left, Stage 0, Grade 2, 0/3 nodes, ER+, HER2- Surgery 7/30/2013 Lymph node removal: Left, Sentinel; Mastectomy: Left; Reconstruction (left): Tissue expander placement Surgery 12/9/2013 Reconstruction (left): Silicone implant Hormonal Therapy 2/9/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 10/9/2016 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Nipple reconstruction
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Nov 11, 2016 02:05PM macb04 wrote:

I had a uni mx and had 3D tattooing by Vinnie Myers . He created a whole Nipple/Areola Complex on the left, then he also tattooed my real right nipple just on the areola part. The matching looks very real. He even created Montgomery Glands on the tattooed areola on the Left, to match my right . I don't know if a PS could have that level of artistic sensibility. I have seen numerous nipple tattoos done by PS's that look strange,kind of like a slice of pepperoni on a breast mound.

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Nov 11, 2016 02:33PM debiann wrote:

My PS office admits that a tattoo artist who knows how to do nipple tats can do a better job than they can in the office, but for me it will be an out of pocket expense. They referred me to a specialist in our area if I wanted to check it out. Of course there is also the most famous tat artist, Vinnie Myers, but he charges A LOT compared to others. His clients seem really happy, though.

My PS also said that if you get the medical tattoo and are not satisfied, a tattoo artist can redo it. That's the route I'm taking for now. My PS actually did a nipple and areola recon. He grafted skin from my hips to make the areolas. Because it is a skin graft, the color is different, kind of a reddish brown. It looks like an areola without tattooing. If it doesn't lighten they said all I will need tatted will be the nipple, which was made from the breast skin and is currently white.



"I live knowing it will be ok when I'm not." Dx 3/2014, IDC, 2cm, Stage IA, Grade 3, 0/2 nodes, ER+/PR+, HER2+ Surgery 4/2/2014 Lumpectomy: Left; Lymph node removal: Left, Sentinel Targeted Therapy 5/7/2014 Herceptin (trastuzumab) Chemotherapy 5/7/2014 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 9/28/2014 Mastectomy: Left, Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Hormonal Therapy 11/4/2014 Arimidex (anastrozole)
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Nov 11, 2016 05:13PM - edited Nov 12, 2016 08:38AM by farmerlucy

I have 3D Vinnie's. I flew from OK to Baltimore and the total for my trip and the tats was less than my deductible. Insurance does not cover them. I did take the full cost as a medical expense on my tax return.Check out his website. Mine are completely flat. Just the tat, so I never have to wear a bra. I would totally trust anyone in his shop to do them too. They learned from the best.

Dx at 51 after a preventive mx that wasn't. Oncotype dx 3. 3D tattoos from Vinnie! PTSD?? You are not alone! Surgery 2/21/2012 Prophylactic mastectomy; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Dx 2/24/2012, IDC, Right, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2- (FISH) Surgery 3/11/2012 Lymph node removal: Sentinel Surgery 7/22/2012 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 4/10/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 4/14/2015 Prophylactic ovary removal
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Nov 11, 2016 10:20PM Janetanned wrote:

Keep in mind that Vinnie isn't the only game in town. There are a number of very good tattoo artist around the country that specialize in areola tattooing. I went to a micropigmentation specialist who works out of my PS office at Penn. She also works in NYC a few days a week. Because the work was done in the office some insurance will pay for it. I lost the papers and failed to file with my company, but it cost half as much as Vinnie so it wasn't such a big deal to just pay out of pocket. Three years later my tattoos still look great. My tattoo artist matched my skin tone and gave the tattoos plenty of texture and a 3-d appearance. They fooled my GYN at first and my MO always remarks how nice they look when she does her exam.

There have been posts listing the various option across the country. Maybe others will give their recommendations.

For the PA/NYC/NJ I recommend Mandy Sauler https://www.pennmedicine.org/providers/profile/mandy-sauler

Janet 11/10/11 BMX/DIEP reconstruction, 1/6/12- 4 AC DD followed by 4Taxol DD, followed by 33 rads, 10yrs hormone blocker Dx 10/11/2011, ILC, <1cm, Stage IIIA, 4/30 nodes, ER+/PR+, HER2-
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Nov 12, 2016 01:40AM Meow13 wrote:

Mac and others, where is the nearest Vinnie Myers for Seattle?

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Nov 13, 2016 11:07AM Jenny867_5309 wrote:

I am also in Seattle. I just finished my mastectomy and was looking ahead to something that would make me feel good a year from now. My bestie came up and we met with Madama Lozonga just below Pike Place. Half her business is breast tattoos. She told me not to let the plastic surgeon do the nipples. I am going to get a tattoo to cover my left breast scars

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Nov 18, 2016 01:40AM macb04 wrote:

Hi Meow13 , what do you mean, Vinnie Myers for Seattle ? Do you mean a good tattoo artist like Jenny867_5309 wrote? Or where did I go to see Vinnie ? I don't know any tatt artists in Seattle . I am thinking of finding one to help me with some under breast tattooing to make my implanted side have a better appearing inframammary fold. I don't want more surgery, but it doesn't look great. What I learned by having a 3d nipple tattoo , is that a very skilled application of pigment can create a very realistic illusion . So that is my plan. I asked Vinnie Myers about doing that,but he said no, thinking I was going to get another surgery some time, and then I would have a line on the breast. No more surgeries for me , so I am going to do what feels right to me which is to get a skilled medical tattooist to help enhance tthe illusion of my under breast fold.

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Nov 19, 2016 01:23AM Meow13 wrote:

Jenny I saw her advertisement. I am thinking of trying it, I have 2 failed tatoos complete fade at doctors office.

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Jul 26, 2017 02:36AM Tamera12315 wrote:

I have a question. I had a bilateral mastectomy twice!! I am very petite and my Dr told me after the last surgery that my skin is so thin now that I would never be able to have recon if needed. My question is, I am wanting to get my scars tattooed but am unsure if my skin can be to one thin for that as well. I'm lost now And just want to be comfy in my skin afain

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Jul 26, 2017 09:12AM - edited Jul 26, 2017 09:16AM by LettyF

Hello LeftDCISWoman,

My PS does or has the tattooing done in his facility by a medical tattooist who comes up from Miami several times a year and she was trained by Vinnie Myers. During the third phase (I still have TEs right now) he will do any lipo and fat grafting with nipple reconstruction should I decide to and my insurance will cover all this. However, my insurance will not cover the tattooing which can just be coloring the areola or making a realistic 3-D tattoo that includes the appearance of the nipple. This is what I think I'm leaning toward and the cost is the same thru my plastic surgeon's office whether is just coloring or the 3-D. The cost of this out-of-pocket tattoo for me is $800 and I had a dbl mastectomy. Your insurance may cover it so I would definitely call a customer service representative for clarification. Good luck and best wishes.

Dx 1/6/2017, DCIS/IDC, Right, 2cm, Stage IIA, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 2/2/2017 Mastectomy: Right; Prophylactic mastectomy: Left Surgery 5/3/2017 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/17/2017 Reconstruction (left): Tissue expander placement Hormonal Therapy 9/5/2017 Arimidex (anastrozole)
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Sep 27, 2017 07:35PM LeftDCISwoman wrote:

Hi, I don't know if anyone responded to your post but Vinnie's asks for an "email evaluation" and they ask a bunch of questions, including you sending pictures. Judging from that, they will let you know if they can do it or not. Hope this helps! LD

Dx 6/14/2013, DCIS, Left, Stage 0, Grade 2, 0/3 nodes, ER+, HER2- Surgery 7/30/2013 Lymph node removal: Left, Sentinel; Mastectomy: Left; Reconstruction (left): Tissue expander placement Surgery 12/9/2013 Reconstruction (left): Silicone implant Hormonal Therapy 2/9/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 10/9/2016 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Nipple reconstruction
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Sep 27, 2017 08:03PM LeftDCISwoman wrote:

Thank you all for your replies to my post. I did drive out to Vinnie Myers shop in MD this August (2017), made the trip from Detroit. It was 1100 miles round trip. I decided to take my family (husband and two kids) and make a mini vacation out of it. The tat was done by one of Vinnie's "team" members, not Vinnie. They were all very nice, but they 'strongly recommended' that I get the 'healthy breast' tattooed also. They did not ask for pre mastectomy pics. I visited their website and on the site they made a big deal of 'making sure the customer has the right color mix', and encouraging the client to be a big part of that process. When I got there, it wasn't like that at all.

The tattoo artist had me wait in the waiting room "while he mixed the color". Then when I got in to the room to get the tattoo, he gave me a slight sample of what he thinks it should look like and I wasn't sure so I just said "ok". I figured they knew what they were doing and it would come out looking okay. But when i took the bandages off a few hours later, I realized that my areola on the left was DARK, kind of brown with a red nipple in the middle, since the nipple was a real nipple grafted from the healthy one. My left breast looked and still looks like of like a target. It has been 7 weeks now and not much has changed. It is still brown.

The artist said I could make the 1100 mile round trip back in a 'few months after it takes time ot heal' but also defended himself by saying that I should have brought 'before pics' if I wanted it to look a certain way. He also said that he was upset that I was not happy, and that I 'agreed on the color choice'. The guy kept talking about how 'it will fade in a little bit of time, just give it time....' and 7 weeks later he said "well you never know with areolas, especially reconstructed ones." I think they should make that a little clearer in their advertising that it might not be what you expect.

My 'healthy breast' looks okay, but of course they do not match and the artist told me he will not be able to get them to match. I would not want the 'healthy breast' to match the recon breast anyways because the recon breast is brown. I have red hair and fair skin, and the areolas used to be pink. Now I feel like Spuds McKenzie.

A few weeks ago, I found Lovely Monkey tattoos in the Detroit area, and after a a consultation with them, they said what Little Vinnie's said was not true about not being able to get the breasts to match. I posted my concerns on a Facebook BC group I joined, and they deleted my comment. I was just trying to warn others that they should bring 'before photos' before going to ANY tattoo artist.

I was able to get the 'pre mastectomy' photos from one of the PS that took pics. That was not the one who actually did the surgery, so I was glad that they had the pics after 4 years and were willing to give them to me. I sent them to Little Vinnie's, and they told me that they would not have been able to tattoo them that color anyways.

***If any of you are considering going to LV for areola tattoos, I strongly suggest getting and bringing and sending them 'pre' photos so they can tell you ahead of time if they can meet your expectations. ***

The Little Vinnie's artist also said he is moving out of state in February, so I'd have to go back to MD sometime between November and February if I want a shot of them doing it right this time.

SHOULD I TRUST THEM? Could some advice here.

Both tattoo artists suggested a possibility is getting a laser tattoo removal to fade the tat before getting it re-done. I'm pretty upset. I have a hard time trusting ANYONE after this experience. Thanks in advance for your feedback. LD

Dx 6/14/2013, DCIS, Left, Stage 0, Grade 2, 0/3 nodes, ER+, HER2- Surgery 7/30/2013 Lymph node removal: Left, Sentinel; Mastectomy: Left; Reconstruction (left): Tissue expander placement Surgery 12/9/2013 Reconstruction (left): Silicone implant Hormonal Therapy 2/9/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 10/9/2016 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Nipple reconstruction
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Sep 28, 2017 12:03AM CarolinaMommy wrote:

um, yikes?

I'm sisterly devastated to hear of your troubles getting your tats to look right! Especially after trying so hard (and for so long!) to just take it in stride, make it a family trip, just try to feel like it's gonna be good and then to be unhappy. Arg. :(

Just a thought bc I went this alternate route- have you considered tattooing something other than nipples? Flowers, stars, birds...if you want small and round? I'm very happy to see my gorgeous Phoenix on the lefty, as a reminder of rising up from the ashes and reclaiming this new body and new sense of self in my own terms. I know it's surely not for everyone, but depending on your options, maybe this is an opportunity for you.

Just a thought. I have no vinnie style experience or knowledge to offer, but hope you find something that celebrates you and your new self.

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Sep 28, 2017 09:57PM - edited Sep 28, 2017 10:02PM by Janetanned

This Post was deleted by Janetanned.
Janet 11/10/11 BMX/DIEP reconstruction, 1/6/12- 4 AC DD followed by 4Taxol DD, followed by 33 rads, 10yrs hormone blocker Dx 10/11/2011, ILC, <1cm, Stage IIIA, 4/30 nodes, ER+/PR+, HER2-
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Sep 28, 2017 10:01PM Janetanned wrote:

I'm so sorry you had a less than perfect experience with your tattoos. It sounds questionable that Vinnie couldn't match your natural color. My cosmetic tattoo artist was able to use my skin tones (redhead/pale freckles) to get a natural look for me. I didn't have pictures, but they sure look like the originals.

However, mine did fade a bit over a two week period. Originally, they were a little too dark for my taste. They have since faded to a perfect tint and have remained that shade for four years now. Maybe yours will fade?

Did Vinnie's guy tell you how he would 'fix' them?


Janet 11/10/11 BMX/DIEP reconstruction, 1/6/12- 4 AC DD followed by 4Taxol DD, followed by 33 rads, 10yrs hormone blocker Dx 10/11/2011, ILC, <1cm, Stage IIIA, 4/30 nodes, ER+/PR+, HER2-
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Sep 30, 2017 09:49AM Kristiina wrote:

i'm so sorry to hear about a bad experience. I'm very interested in this topic. Plastic surgeon versus tattoo artist for Areola

Kristiina Dx 12/14/2016, ILC, Right, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 12/26/2016 Lumpectomy: Right; Lymph node removal: Sentinel Surgery 1/31/2017 Mastectomy: Right; Reconstruction (right)
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Sep 30, 2017 05:57PM Janetanned wrote:

Kristina - Some PS offices now use a cosmetic tattoo artist (micropigmentation specialist) to do the areolas. The woman who did mine works out of a few different medical offices. She is a tattoo artist who studied art in college and was trained in cosmetic/medical tattooiing. I really appreciated the convenience of having the work done in a familiar, clean, and comfortable office. I found that the cost was also significantly lower than Vinnie. Not to mention, I didn't have to wait forever for an appointment, I didn't have to travel, and some insurance companies will pay if the tattoos are done in the doctor's office. The results are perfect and exactly what I wanted.

Janet 11/10/11 BMX/DIEP reconstruction, 1/6/12- 4 AC DD followed by 4Taxol DD, followed by 33 rads, 10yrs hormone blocker Dx 10/11/2011, ILC, <1cm, Stage IIIA, 4/30 nodes, ER+/PR+, HER2-
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Nov 6, 2017 08:19AM - edited Nov 6, 2017 08:40AM by LeftDCISwoman

Thank you all for your feedback. I am sorry about the delay in following up on this post. The week after i posted about the tattoos I was diagnosed with arthritis in my ankles, and it was determined to be a side effect from taking Tamoxifen. Then that following week I had lockjaw, another side effect. So the tattoos took a back seat. Janetanned, the PS actually used an 'in house' artist for your tats? I am interested in seeing if perhaps I might be able to find someone like that in my area, if they would 'fix' someone else's work. Right now I have to also have a waiting period between tattoos so I can get scans to make sure I don't have cancer in the other breast. So I cannot get a tattoo before I get my scan results. LV did say they would 'fix' the tattoo if I went out there before the end of the year, but I don't know if I can trust them. LV does not have a waiting list, because they now have 3 other tattoo artists working with them. Janetanned, I will look into your solution, thank you so much for sharing!


Dx 6/14/2013, DCIS, Left, Stage 0, Grade 2, 0/3 nodes, ER+, HER2- Surgery 7/30/2013 Lymph node removal: Left, Sentinel; Mastectomy: Left; Reconstruction (left): Tissue expander placement Surgery 12/9/2013 Reconstruction (left): Silicone implant Hormonal Therapy 2/9/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 10/9/2016 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Nipple reconstruction
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Jan 16, 2018 10:22PM Mommyathome wrote:

hi. I am planning to get an artistic tattoo with flowers and butterflies so when I look in the mirror I don't just see my nippleless scarred breasts.

Looking for feedback from anyone else who has done this? Was it a positive experience? Did it hurt?

Dx 11/20/2013 Surgery 11/20/2013 Lumpectomy: Left Dx 12/4/2013, LCIS Dx 12/4/2013, DCIS, 1cm, Stage 0, Grade 2, ER+/PR+ Surgery 1/29/2014 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 6/2/2014 Reconstruction (left); Reconstruction (right) Surgery 7/1/2014 Prophylactic ovary removal Surgery 3/23/2015 Reconstruction (left)
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Jan 17, 2018 07:52AM Kristiina wrote:

Thank you So sorry about the long delay in reply my words did not alert me. My plastic surgeon said he could do it but he didn't sound very convincing that he would do a good job. So for $700-800 but it's worth it to get a good job somewhere. I feel there's no rush and I will take my time deciding who to go to though. I live about an hour and a half from New York City and Connecticut

Kristiina Dx 12/14/2016, ILC, Right, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 12/26/2016 Lumpectomy: Right; Lymph node removal: Sentinel Surgery 1/31/2017 Mastectomy: Right; Reconstruction (right)
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Jan 17, 2018 07:54AM Kristiina wrote:

dear mommy at home, I am curious as to what you decide!

Kristiina Dx 12/14/2016, ILC, Right, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 12/26/2016 Lumpectomy: Right; Lymph node removal: Sentinel Surgery 1/31/2017 Mastectomy: Right; Reconstruction (right)
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Jan 17, 2018 05:03PM Jackster51 wrote:

Kristina, I live in Los Angeles and do 3D nipple tattoo's (And I have them!) I can look for someone good in your area if you like??

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Jan 20, 2018 09:05AM Janetanned wrote:

Kristina - I used Mandy Sauler who worked out of my PS's (Penn) office one day a week. She was terrific. My tattoos have withstood the test of time and still look perfect 5 years latter. She was very patient with me and worked with me to get the right color to match my 'redhead' skin tones. Mandy is also very gentle and easy to talk to, which for me was very important. At that time she was much less expensive than the tattoo artist who was famous in our area. I think her rates may have gone up.

Mandy has offices in NYC, NJ, and PA.

https://www.saulerinstitute.com/

Janet 11/10/11 BMX/DIEP reconstruction, 1/6/12- 4 AC DD followed by 4Taxol DD, followed by 33 rads, 10yrs hormone blocker Dx 10/11/2011, ILC, <1cm, Stage IIIA, 4/30 nodes, ER+/PR+, HER2-
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Jan 20, 2018 11:10AM Kristiina wrote:

Thank you Jackster, I live in SW Connecticut. About 1 1/2 hours to NYC.

Kristiina Dx 12/14/2016, ILC, Right, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 12/26/2016 Lumpectomy: Right; Lymph node removal: Sentinel Surgery 1/31/2017 Mastectomy: Right; Reconstruction (right)
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Jan 20, 2018 11:11AM Kristiina wrote:

Thank you Janetanned, I will go to NYC if I cannot find anyone closer.


Kristiina Dx 12/14/2016, ILC, Right, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 12/26/2016 Lumpectomy: Right; Lymph node removal: Sentinel Surgery 1/31/2017 Mastectomy: Right; Reconstruction (right)
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Jan 20, 2018 08:40PM - edited Jan 20, 2018 08:43PM by Mommyathome

Kristiina,

I'm planning to get an artistic tattoo on both breasts. I spoke with the tattoo artist about what I'd like and that I don't want it right on the scar; eventually I will need another surgery to swap out the implants. I think they recommend every 10 years to do that.

She looked at my scars and I gave her pics of ideas I have for the tattoo and she's in the process of sketching it out for me to see. I'm not rushing! I want to see it, tweet it and make sure it's where and what I want. I did contact my plastic surgeon who did my reconstruction after mastectomy to inquire about getting numbing cream or lidocaine. I think I'm most nervous about the pain.


Are you looking to get tattoos? What has your experience been? Type/stage at diagnosis, treatment, etc

I live in Connecticut. Where about a in Connecticut are you?

Dx 11/20/2013 Surgery 11/20/2013 Lumpectomy: Left Dx 12/4/2013, LCIS Dx 12/4/2013, DCIS, 1cm, Stage 0, Grade 2, ER+/PR+ Surgery 1/29/2014 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 6/2/2014 Reconstruction (left); Reconstruction (right) Surgery 7/1/2014 Prophylactic ovary removal Surgery 3/23/2015 Reconstruction (left)
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Jan 20, 2018 10:52PM Jackster51 wrote:

Kristina, Mandy is awesome! If you can get to NYC I'd highly recommend her. If I think of anyone closer I'll let you know.

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Jan 21, 2018 08:12AM Kristiina wrote:

Dear mommyathome, I am not brave enough to do designs but quite curious about it. I live in Ridgefield. And you

Kristiina Dx 12/14/2016, ILC, Right, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 12/26/2016 Lumpectomy: Right; Lymph node removal: Sentinel Surgery 1/31/2017 Mastectomy: Right; Reconstruction (right)
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Jan 22, 2018 10:13PM - edited Jan 22, 2018 10:16PM by Mommyathome

I live in thomaston. Check out the thread artist tattoo after mastectomy. I posted a pic of tattoo I'm thinking about


Dx 11/20/2013 Surgery 11/20/2013 Lumpectomy: Left Dx 12/4/2013, LCIS Dx 12/4/2013, DCIS, 1cm, Stage 0, Grade 2, ER+/PR+ Surgery 1/29/2014 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 6/2/2014 Reconstruction (left); Reconstruction (right) Surgery 7/1/2014 Prophylactic ovary removal Surgery 3/23/2015 Reconstruction (left)
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Jun 20, 2018 10:40AM woodsyny wrote:

Janetanned,

Mandy sounds amazing! I am on the last journey of my reconstruction and live 2 hours north of NYC. You said Mandy had offices in NYC? Any info would be appreciated! I am about 4 hours from Philly.

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