One in eight American women will develop breast cancer in their life, and treating it—or even preventing it—can often leave them feeling like strangers in their own bodies. This is increasingly true when the treatment requires a mastectomy—the surgical removal of one or both breasts. For some mastectomy patients, part of the healing process involves breast reconstruction, and for many of them, nipple tattoos are an important part of the procedure as well. However, research has found that only 32 percent of all nipple tattooing is done in the plastic surgery offices that perform breast reconstruction, and many practices (23 percent) don’t even provide patients with referrals for nipple tattoos.
To fill this gap and help patients reclaim their bodies post-mastectomy, some tattoo artists offer realistic nipple and areola tattoos to breast cancer survivors. These artists aren’t always easy to access, though (either because they work in another state or country, or they’re too busy) and their procedures can be extremely expensive since they provide such a highly specialized service.
In an attempt to make realistic nipple tattoos more accessible, a team of plastic surgeons and researchers from Mayo Clinic, University Hospitals Cleveland Medical Center, and University of California, Davis, has developed what they call a “nipple-by-number” device. As outlined in an article published in Plastic and Reconstructive Surgery, this device is designed to make the process easier and less expensive while still “ensur[ing] an accurate, consistent, and personalized aesthetic result during three-dimensional nipple-areola tattooing.”
How does it work, exactly?
For a tattooer, doing realistic tattoos of any kind requires a deep understanding of light and shadow—and how to create the illusion of light and shadow using ink. It’s a skill that takes a great deal of practice to master. But the “nipple-by-number” device claims to eliminate the need for that in-depth knowledge and enable even the most novice tattooers to ink realistic nipple tattoos. In fact, it was created to be used by plastic surgeons with little to no tattooing experience; the idea being that this will help patients more readily access an otherwise highly specialized service.
So how does it work? The device consists of four 3-D printed stencilized layers that are applied one at a time and used to guide the tattoo needle. The first stencil is the largest, and creates a base layer that illustrates the areola. The following layers are then used to tattoo the Montgomery tubercles (the little dots circling the areola), the nipple, and to add shading. Using the device, patients will be able to get custom tattoos (they can bring in reference photos of their pre-surgery nipples that the person doing the tattoo will attempt to duplicate) or a standardized nipple-areola design.
Once the tattoo is complete, patients are asked to follow standard tattoo aftercare protocols until their new nipple tattoos have healed.
One thing the journal article skips over, though, is the training needed to effectively use the device. While it’s meant to be straight-forward, some training and practice is surely necessary to teach people the basics of the device and how to use it to successfully create the illusion of depth that defines a realism tattoo. Nevertheless, the idea is that users will be able to create that depth using the device, simply by following its stencilized layers.
The device is promising, but it isn’t perfect—yet.
Another part of the appeal of nipple tattoos done using this device is that they’re easier to create, and therefore less expensive than a piece done by a normal tattooer. In its research, the team behind the device found that the national average cost of nipple tattoos is $640 for one breast and $956 for both breasts. The “nipple-by-number” should lower that cost significantly.
However, it’s also worth noting that the examples of tattoos done using this device don’t look nearly as realistic as those done by artists who specialize in nipple tattoos. Professional artists who have dedicated their lives to mastering realism tattoos and who specialize in nipple tattooing will almost always achieve a better, more personalized result than a template. Some of those artists are Piret Aava, Shaughnessy Otsuji, Sylwia Dobrowolska, and Sylwia Nawrot. Still, we don’t doubt that the “nipple-by-number” device is promising, although it does likely require a bit more work before it can come close to creating the kind of hyper realistic 3-D nipple tattoos that specialized tattooers are able to provide.