The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on September 21, 2021.

Nipple reconstruction and nipple tattoos

If you’ve undergone a mastectomy, you may decide to also have breast reconstruction surgery. In most cases, when the breast is removed, the nipple and the darkened area around it—the areola—are removed as well.

Breast reconstruction creates new breasts in place of what was removed, and not everyone will elect to have the nipple reconstruction procedure that comes later. If you choose to, you have several options when it comes to reconstructing your nipple. Surgery to create a new nipple or nipples may be an option, but it's not the only one you have. You can also decide to have nipple tattooing or use prosthetic nipples.

Learn more about what options are available when it comes to nipple and areola reconstruction and nipple tattoos, and factors to consider when weighing each option.

Nipple reconstruction surgery

After going through breast reconstruction, the final surgery is making the nipple. This is a separate procedure usually done three to four months after the reconstruction surgery, so the breast has enough time to heal.

There are a few different ways to get the nipple tissue for this reconstruction. Most of the time, to recreate the nipple and areola, your surgeon will use the skin of the reconstructed breast to form a nipple and stitch it closed. Another way is to use a skin graft, where tissue from some other part of your body, such as your inner thigh, is taken to form the nipple.

What to consider

Your surgeon's goal is to be able to match this new nipple to your other one, or match both nipples to each other if you had both breasts reconstructed. The position, shape, size and projection—or how much they stick out—are all taken into consideration. You have a part in this conversation and process as well. You’ll share all of the decisions with your care team.

Nipple reconstruction surgery can make the area resemble a natural nipple, but it won’t necessarily give the nipple a natural color. If you want the nipple to have a color similar to a natural breast, or to have both nipples match, tattooing is an option after surgery. This is an additional procedure that can be done several months after the nipple is reconstructed.

How to prepare for surgery

Nipple reconstruction is usually an outpatient procedure. Because of this, you may not need to do a lot to prepare. Make sure to get your questions answered by your provider so you feel as comfortable as possible.

Risks of nipple reconstruction surgery

With any reconstruction surgery, infection is always a risk, so make sure you understand your post-surgical instructions and call your doctor if you notice anything concerning in the area, like pus, a bad smell, or if you have chills or fever. One October 2013 study in the European Journal of Plastic Surgery points to nipple reconstruction being a high-risk procedure for people who have had radiation therapy.

3D nipples (nipple tattoos)

No, nipple tattoos aren’t actually three-dimensional, but they look like they are. If you don't want to, or are unable to, have another surgery, another option may be nipple tattoos. This can be performed by a plastic surgeon skilled in tattooing, or it can be done by another professional, even a licensed tattoo artist experienced in nipple tattoos. Using shades of pigment, these flat tattoos can be created to look three-dimensional.

What to consider

You have the option to have tattooing of the areola, the nipple or both. You can work with the professional doing the tattooing on how you want the pigmented color to look. Nipple tattoos can be a good option if you don’t want to have another surgery.

How to prepare for a 3D nipple tattoo

Having a 3D nipple procedure is similar to having a tattoo anywhere else on your body, so there may be some discomfort during the procedure itself. You won't usually need to do anything special to prepare for this procedure.

Risks of nipple tattoos 

Infection at the site could happen, so make sure you're following care instructions for the tattooed area at home, such as washing the area with soap and water and applying an antibacterial ointment.

Prosthetic nipples

The least invasive of nipple options is prosthetic nipples—it doesn’t require additional surgery or tattoo needles. Nipple prosthetics can give you the appearance of nipples, but they’re removable. Nipple prosthetics are made of silicone or other materials, so they look and feel close to the real thing. These prosthetics can be positioned and attached to the breast, and you can take them off whenever you'd like.

What to consider

Nipple prosthetics are a great option if you're still trying to make a permanent decision about your nipples. You can use them and take them off whenever you want.

How to prepare for prosthetic nipples

Check with your insurance to see if they will cover nipple prosthetics. You may also need to do some research to find reputable companies that sell these prosthetics.

Risks of prosthetic nipples

Nipple prosthetics need to be cared for according to their directions, and you’ll need to inspect the site periodically to make sure your skin isn’t irritated by the prosthetic.