Areola Micro-pigmentation

What is micro-pigmentation?

It is a type of semi-permanent colour (cosmetic tattoo) applied to the skin of your breast to recreate the colour and shape of the nipple areola after breast reconstruction.

How is micro-pigmentation carried out?

A trained and experienced practitioner will perform the procedure, in an outpatient clinic. You will be offered a topical anaesthetic (in the form of a cream, which is applied at least 30 minutes before the procedure is carried out) to numb the area.

What are the benefits and risks?

You will be involved in choosing the colour match of your nipple in consultation with your breast care nurse. We aim to find as realistic a colour match for your nipple areola as possible and will try to match it to your remaining nipple (if you have had a double mastectomy, you will be able to choose the colour).

However, micro-pigmentation is an invasive procedure and is not without risk. The main risks include:

  • Not achieving an exact colour match
  • Fading of colour over time
  • Scarring
  • Pigment migration or spreading
  • Uneven pigment colour
  • Slight skin irritation

How many treatments will I need and how permanent is it?

Most patients require more than one treatment. After initial treatment an appointment for review at six weeks will be offered. Some patients require further follow up treatments every year to achieve and maintain the desired outcome.

100% success cannot always be guaranteed and the extent of the procedure depends on what changes are desired and the method the practitioner deems appropriate.

What factors may affect the results?

The results of micro-pigmentation are partially determined by variations in skin type, and can be affected by:

  • Medication
  • Natural skin tones
  • Skin characteristics (dryness, oiliness, sun damage, thickness, and colour)
  • PH balance of the skin (acidity)
  • Alcohol intake
  • Smoking
  • Individual healing ability
  • Illness

If you have a heart condition, epilepsy, haemophilia or other clotting disorder, or if you have had hepatitis over the past 12 months, you must inform your practitioner before the procedure.

Allergy test

You will be offered a skin patch test prior to the procedure. It is advisable to have the test if you have a history of any type of allergy. The purpose of this test is to detect allergies or other reactions to the topical anaesthetic and pigments used during the procedure. A full 24 hours is needed after the skin test to see if allergies occur.


All equipment used is sterile. Disposable needles are used for each individual procedure and disposed of immediately after use.

What happens during the procedure?

The micro-pigmentation procedure usually takes 30-60 minutes, depending on individual requirements. Completion time varies according to:

  • The position, width and depth of the nipple areola area
  • The depth of colour to be matched
  • Acceptance of the pigment to skin type

Depending on the sensitivity of the area, you may require a local anaesthetic for the procedure. This will be applied as a topical cream at least 30 minutes before the procedure.

The pigment is applied using a pen-like device, which basically works like a miniature sewing machine: the needles move up and down really quickly, penetrating the outer and inner layers (epidermis and dermis) of the skin, implanting the coloured pigment. The practitioner holds the machine with a steady hand while guiding it along the skin. The pigments are built up using dots, lines and/or a circular motion.

What should you expect after the procedure?

You will experience slight swelling and redness following the procedure and the skin may feel ‘tight’. These symptoms will subside within 1-7 days depending on how sensitive your skin is.

You should be able to resume normal activities immediately following the procedure; however, use of cosmetics, excessive physical activity and exposure of the affected area to the sun should be avoided until the area is fully healed.

Avoid swimming during the healing phase as the pigment is at risk of bleaching from chlorine or saltwater.

Over the initial few days, the pigmented area of skin will form a scab. This will last for 14-21 days, when exfoliation of the dead cells (the scab) will occur as healing takes place. You will then notice fading of the pigment and softening of the colour.

It is important that the healing process takes its natural course. Scarring can occur it the scabs are removed or knocked off prematurely.

Skin care instructions

The following instructions must be carefully followed for at least two weeks after the procedure to ensure pigment retention, prevention of infection and successful results.

Before showering or bathing, apply a light coating of Vaseline to the areola. This protects the area by  enabling the water to bead off the damaged tissue.

If a crust appears on the areola, do not pick or peel it off, as this would remove the pigment as well as the crust.

Do not use soap, sunbathe, swim, sauna or Jacuzzi during the two weeks following both the initial and follow up procedures.

To prevent infection, do not touch the pigmented area with your fingers until it is completely healed. Use cotton buds to apply ointments.

Should you have any further questions or concerns, please contact:

Jackie Skinner
Breast Care Nurse
Spire Bristol Hospital
0117 980 4137 / 07872 672 775

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