These are exciting times if you find yourself in need of a new breast or two! After the pain, stress, and fear of a single or double mastectomy, breast cancer patients find themselves with what is hopefully an encouraging array of options. Do you reconstruct? Do you go for an amazing cover-up tattoo? Decide you’re done with breasts and go flat? There are options, ladies!
No one should rush their decision. How you choose to reconstruct (or not) is deeply personal and will be a big part of helping you make peace with your new post-cancer body. There are several good reasons to just go flat and embrace a streamlined lifestyle: cost or health issues may be prohibitive to reconstruction, staying flat may feel like the best way to feel true to yourself, and implants won’t have the same sensitivity to touch that a flat chest will. And a big plus of going flat is that no further surgeries are required—one and done!
Some women choose to wear a prostheses, and there are multiple options if you want to go that route. A prosthesis is another great option for women who want to be 100% done with surgery.
But for many women, having one or both breasts reconstructed is extremely important. They feel reconstruction will help them feel whole again or more confident, and if a woman underwent a single mastectomy, reconstruction of the removed breast may feel like a practical step to maintain symmetry. If it’s important to a woman to have one or both breasts reconstructed, then she will have to answer a host of new questions. One of the trickiest is: What do I do about nipples?
The decision can be overwhelming, because it’s not a simple “Yes” or “No.” It’s “Permanent, semi-permanent, or temporary?” and “Now or later?” and of course, “What size, shape, height, and color?”
Goodness gracious. Since when did nipples become as customizable as your coffee order?
But we’re all for it. Here are 4 big considerations when starting your journey to new nipples.
1. Do I Care About Nipples?
Some women feel it’s important to have their breasts reconstructed but are less concerned about nipples. A smooth, round mound is fine with them—no protrusion or color needed. Some of those who think nipple-free is the way to be will opt for decorative tattoos over their breasts (like these amazing ladies).
The pro of not caring about nipples is that you’ll avoid additional surgery and its associated risks. But some women think nipples are essential and want them for symmetry, a sense of normalcy, or even the sexual pleasure of their partner. If that’s the case, then there are more questions to answer!
2. Do I Want My Nipple to Project?
Sometimes a woman’s natural nipple can be preserved and reattached after a mastectomy. That’s definitely one way to achieve natural-looking results and retain a sense of familiarity with your body. But nipple preservation is not always possible, and it may be that a woman wants to change how her nipple looks anyway.
If that’s the case, and a projection is important, then a plastic surgeon can create a projection using your own tissue. The reconstructed nipple will likely collapse a bit after surgery, and if two were reconstructed, they may do so unevenly. So if symmetry is important, reconstructed nipples do pose some risks, and there will likely to be little if any sensation in the reconstructed breast and nipple (though they still may be an important part of a couples’ sex life). But breasts and nipples are rarely 100% symmetrical to begin with (sisters, not twins) so a bit of asymmetry should not be too concerning. If you want to create a colored areola, you can opt for nipple tattooing (more on that coming).
Or, if you’re looking for less of a commitment while you make your final decision, try stick-on nipples! The downside is that stick-ons may come off when you don’t want them to, but if you don’t like the color or the placement, just peel them off and try again! Stick-ons are a great option if you’re not ready for a long-term nipple relationship.
3. What if Projection isn’t important?
If projection is not important, then 3D nipples tattoos may be right for you! There are two main types, and both are often referred to as 3D tattoos, so it’s important to know the differences.
Micropigmentation is a process where a micropigmentation specialist or nurse injects pigment, not ink, into the dermal layer of the skin. The procedure is typically performed at a clinic. The procedure takes about an hour and there are minimal risks that include scarring, irritation, uneven color, or infection.
Micropigmentation does fade, and touch-ups are recommended about every two years. But the advantage of that is that if things don’t turn out 100% perfect, they can be adjusted. As your skin changes over time, your coloring can be adjusted so that your nipples still appear in the correct place. It usually takes a couple of sessions to get the coloring just right, and multiple pigments are blended to create an impressively realistic 3D look.
Classic 3D Nipple Tattoos
Another more permanent option is to use a tattoo artist that specializes in 3D nipple tattoos. Tattoo artist Vinnie Meyers has gained considerable notoriety creating incredible nipple tattoos for women with reconstructed breasts with and without the created projection.
To be clear, these tattoos are referred to as 3D because the artist uses multiple colors to create a three-dimensional look, but the tattoo will not change the shape of the actual breast. But if you’re looking for a 3D look without needing to schedule follow-up appointments, a classic nipple tattoo may be the way to go. The risks are similar to those of micropigmentation, but with a classic tattoo your nipple will likely take longer to heal.
4. Pre-Tattoo Considerations
While there’s no rush to decide what you’d like to do about nipples, you should talk to your surgeon before your breast reconstruction about tattoos (either type) if you’re considering them. Your surgeon can advise you on placement and if there’s any skin that might be too thin to be tattooed. You want to avoid having a tattoo needle puncture too deeply and hit an implant. Your surgeon will also have helpful advice about how sensitive you can expect your breast to be and therefore how painful getting a tattoo might be. Your medical facility may also be able to perform an areolocation, a laser procedure that determines the best spot for your new nipple and areola.
So there you have it! While losing part of your body is heartbreaking, making reconstructive decisions that are best for you can be an important part of the healing process. Remember to take all the time you need to consider each decision, and only make a move when you feel ready and confident. Keep fighting, friends!
Katie Taylor started writing in 5th grade and hasn't stopped since. Her favorite place to pen a phrase is in front of her fireplace with a cup of tea, but she's been known to write in parking lots on the backs of old receipts if necessary. She and her husband live cozily in the Pacific Northwest enjoying rainy days and Netflix.