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3D Nipple–Areolar Tattoo: It’s Technique, Outcomes, and Utilization

  • Original Article
  • Breast Surgery
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Three-dimensional (3D) nipple–areolar tattoo is a novel approach to nipple–areolar complex reconstruction for which little data exist. Our aim was to evaluate 3D nipple–areolar tattoo outcomes and investigate if patient factors, payer status, surgeries, or therapies affect tattoo utilization.

Methods

Patients pursuing skin-sparing (SSM) or attempted nipple-sparing mastectomy (NSM) with breast reconstruction from 2008 to 2019 were reviewed. Outcomes included frequency of 3D tattoo, post-procedure complications (infections, or other local adverse sequelae), and rates, indications, and timing of revisions. Patient factors, payer status, surgeries, and adjuvant therapies underwent univariate analysis comparing rates of 3D tattoo and revisions.

Results

A total of 191 patients were identified; median follow-up was 4 years. The majority of patients were white (165, 86%), married (146, 76%), and post-menopausal (97, 51%), with private insurance (156, 81%). Surgeries included SSM (172, 90%) or attempted NSM (19, 10%) with implant (154, 81%) or autologous reconstruction (37, 19%). Sixty-two patients (32%) underwent 3D nipple–areolar tattooing. No post-procedure complications occurred. After tattooing, 20 patients (32%) pursued revisions, the majority due to color fading (12, 60%). Average time from tattoo to completion of revisions was 5.6 months. Patients undergoing autologous reconstruction had a higher rate of 3D tattooing (p < 0.001). Adjuvant radiation led to a higher rate of revisions (p = 0.02). Patient factors, payer status, index mastectomy, and chemotherapy did not significantly affect rates of 3D tattooing or revisions.

Conclusions

3D nipple–areolar tattoo utilization is likely unaffected by age, marriage, menopause, or payer status. Radiotherapy and color fading can lead to more revisions.

Level of Evidence IV

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Authors and Affiliations

  1. Department of Surgery, Mayo Clinic, Phoenix, AZ, USA

    Jacob B. Hammond & Eric T. Siebeneck

  2. Division of Plastic and Reconstructive Surgery, Mayo Clinic, Phoenix, AZ, USA

    Chad M. Teven, Robert W. Bernard, Heather D. Lucas, William J. Casey, Erwin A. Kruger & Alanna M. Rebecca

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  1. Jacob B. Hammond
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  2. Chad M. Teven
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  3. Robert W. Bernard
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  4. Heather D. Lucas
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  6. Eric T. Siebeneck
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  7. Erwin A. Kruger
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  8. Alanna M. Rebecca
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Correspondence to Alanna M. Rebecca.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Hammond, J.B., Teven, C.M., Bernard, R.W. et al. 3D Nipple–Areolar Tattoo: It’s Technique, Outcomes, and Utilization. Aesth Plast Surg 45, 453–458 (2021). https://doi.org/10.1007/s00266-020-01967-w

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  • DOI: https://doi.org/10.1007/s00266-020-01967-w

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