November 16, 2023 Author : Cristina Frutuoso Mastectomy, or surgical removal of the breast, is one of the treatment options that may be indicated for breast cancer. Breast reconstruction after a mastectomy is a reconstructive plastic surgery that allows to recover the volume of the breast and nipple but cannot restore the different natural color of the skin of the areola and nipple . One of the possibilities currently available to solve this issue is areola micropigmentation . This marking of the breast skin with pigments restores the visual effect of the skin color of the areola and nipple and complements the surgical reconstruction. It mainly has aesthetic objectives, but having again an almost natural appearance in breast improves self-esteem and quality of life. Areola micropigmentation is not just intended for women who have undergone a mastectomy for breast cancer. It can also be used after burns or other injuries that have disfigured the areola and nipple or in cases of congenital defects . The pigments used in areola micropigmentation are not the same as those used in common tattoos, nor are the same instruments and equipment used. How is areola micropigmentation done Three to six months must pass between breast reconstruction surgery and areola micropigmentation, so that recovery from surgery is complete and the breast and nipple are in their final position. This period also varies on whether radiotherapy is performed, as this has effects on the skin. A medical evaluation is essential to ensure ideal conditions and decide on the date for micropigmentation . Before the procedure, the color or colors to use are chosen. There are several colors available so that it is possible to choose, for each woman, the most suited. It is common to use more than one color to achieve the greatest possible similarity to the contralateral breast. It is also possible to opt for bilateral micropigmentation, but there are always differences between the areolar skin of the operated and non-operated breasts and, therefore, the behavior resulting from the application of the pigment may differ. The pigment application area is designed to check the balance and symmetry of the areola and nipple on both breasts. In most cases, micropigmentation is performed with prior application of a local anesthesia, but this may also not be used as the procedure is generally well tolerated. Therefore, the use anesthesia is related to individual sensitivity and options . The procedure uses a disposable device that has several thin needles that move up and down quickly, penetrating the skin and depositing the pigment. A treatment session takes approximately one hour. The desired final color is not immediate. After the treatment it is darker and then lightens over one to two weeks. More than one session is usually required to achieve the desired effect. Approximately 3 months after the last scheduled session, the desired final effect is present. Areola micropigmentation is performed on an outpatient basis (without hospitalization) and it is not necessary to miss work or change most daily activities. It is recommended that in the first few days after micropigmentation sessions: Do not wear tight clothing; Do not perform activities that involve force or traction on the breast; Do not take a bath at home (prefer shower), on the beach or in swimming pools, Follow all instructions given, including those regarding the local application of creams or other products. It is also important to know Like any invasive procedure, areola micropigmentation can have risks and undesirable effects . After treatment there may be some redness and swelling, which disappear within a week. Small bleeding, skin irritation, allergic reaction to the pigment and risk of infection are also possible. Scars may form, especially in people prone to keloids. Changes in the shape of the nipple achieved in breast reconstruction surgery may occur. Pigment may migrate out of the area to be colored. It is not possible to guarantee that the final color achieved will be exactly what it was before surgery, as each woman's skin may react differently to the pigment and color chosen. The final color obtained is not lifelong. It will lighten over time, especially after 3-5 years. This happens in micropigmentation and not in a normal tattoo because in the latter the pigments are different and are placed in a deeper layer of the skin. However, it is possible to touch up again and brighten the color of the areola and nipple . The results of micropigmentation depend on the type and characteristics of the skin and on factors such as: Taking some medications; Sun exposure; Lifestyles, particularly tobacco and alcohol consumption; Swimming in pools treated with chlorinated compounds. You should talk to your surgeon, who is the person best suited to advise you on the best option for your case. Meet the obstetrics-gynecology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
