Everything You Ever Wanted To Know About Getting An Areola Tattoo

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I can’t believe it’s been 10 years since my triple negative breast cancer diagnosis. The chemo. Multiple surgeries. Having no idea what my body would look like once I completed the entire treatment. I waited a few months after my final reconstruction surgery to tackle my nipple reconstruction. I’m glad I went this route because I was able to achieve a natural result which still looks pretty good after all this time. With one exception.  The areola tattoo was practically gone,  so I gave my good friend Marnie Rustemeyer a call. Marnie is a restorative and cosmetic tattoo artist with an expertise in paramedical tattooing, permanent makeup, scalp repigmentation, nipple tattooing, tattoo removal, and microneedling. Marnie is a former Wall Street professional, thyroid cancer survivor, and breast cancer previvor who recently joined NYBRA Plastic Surgery in Great Neck, N.Y.

NYBRA offers a comprehensive array of breast reconstruction procedures and support services with a holistic approach designed to facilitate real, authentic healing. If you are considering mastectomy and reconstruction or find yourself unsatisfied with prior reconstruction, the surgeons at NYBRA Plastic Surgery can help guide you through your journey.

Before meeting with a hairstylist or makeup artist, I always like to share a little inspiration to achieve the desired look.  So in true Melissa fashion, I did some online research to see if there were any celebrity “nips” that I liked. You know what? Anne Hathaway has good ones! On the smaller side and a pretty shade of pink. My dear friend Andi Oller can relate to this process, as she requested Marilyn Monroe’s nipples and Marnie delivered!

Upon arrival at NYBRA, I was greeted by Marnie and Dr. Ron Israeli, M.D., a nationally recognized expert in breast reconstruction and a founding partner of NYBRA Plastic Surgery. Before we got started they had a surprise guest waiting for me. Fearless breast cancer advocate Irina aka @mutant_strong was there for a breast revision follow up and wow, she looks amazing!

Marnie began the process by using a stencil and Sharpie to outline the placement of the areolas. She then blended several ink colors until we found just the right one for my skin tone. Marnie LOVES Hall & Oates so she put them on and began to create my areola tattoos. It was a little prickly at first, but I hardly remember the rest because we had so much fun catching up while she was doing it!

I must admit, at the very end when I saw my brand new areola tattoos I became overwhelmed with emotion. I felt as though I had regained a part of me that was lost for some time. Marnie shed a tear also, it was a very sweet yet powerful moment that I can hardly put into words.

I had the opportunity to interview Marnie about the entire process, read on for all of the details:

Q. What is the best way to prepare for your appointment, what are the do’s and don’t?
One week before the appointment, discontinue the use of any steroids, aspirin, ibuprofen or supplements such as fish oil. Do not drink alcohol or caffeinated beverages 24 hours prior to the procedure or take blood thinning medication unless medically necessary. These can cause the blood to thin which will affect the tattoo process as well as the outcome of the tattoo.

Q. What is the best way for the patient to prepare for an areola tattoo in terms of the size and shape that they’re looking for? Do you like when we share inspirational photos?
A. An important thing to remember is that you might not be the same size, shape or even color that you were prior to having surgery. For example, you might have been large breasted with large areolae but now have smaller breasts. You probably wouldn’t want the same size nipple tattoo on your smaller breast! When we get started with the tattoo process, I will look at your breast shape and size and draw some examples of what I think fits best with your new reconstruction.  I’ll ask you to look in the mirror to let me know what you think. If you agree, I will secure the design with surgical marker and begin swatching colors. Yes! I think it’s so much fun when patients send nipple inspiration! Plus, it gives me an idea of what you’re looking for.

Q. Andi Oller (an awesome triple negative breast cancer thriver and friend of mine) told me she requested Marilyn Monroe’s nipples from you, and you delivered! Are there any other celeb inspired nipples that have been requested?
A. Marilyn Monroe is the top request and now I have Anne Hathaway!

Q. Do you perform a consultation first? What happens during the consultation?
A. During the consultation which lasts about 30 minutes, I review your medical history, the pre and post procedure instructions, take photos, walk you through what to expect on your 1st and 2nd appointment and answer any questions you may have.

Q. Do you and most other restorative tattoo artists accept insurance?
A. Insurance should cover all or part of your nipple tattoos. If you are a patient of NYBRA Plastic Surgery, we will submit to insurance on your behalf. Otherwise, we will provide you with a LOMN to submit to your insurance company for reimbursement. Additionally, we are a partner with the AiRS Foundation, who can provide grant funding for patients who qualify.

Q. You used a stencil on me first with a Sharpie pen. Please explain this process.
A. I used a measuring device to determine a size that I felt would be appropriate for your breast size and shape.  I also took into consideration your previous tattoos which had faded with visible remnants of pigment that I wanted to cover with the new tattoo.

Q. Is the procedure painful? How do you prepare the skin before you begin the tattooing?
Since there can be loss of sensation following a mastectomy and sometimes multiple reconstructive surgeries, there is usually no pain associated with the tattoo procedure. If you do have any discomfort, I will apply a topical anesthetic to make you more comfortable.

Q. How do you decide on the color?
A. If you don’t have a previous tattoo, I look at your skin tone (taking into consideration where the skin is from – such as with a DIEP Flap), color of the scars (white, purple, red), and determine if you have had radiation in the area we are tattooing as this can affect the color of the tattoo. I’ll mix some swatches to apply to your skin and have you look at them as well to agree on a color.

Q. What type of ink do you use, and does it affect the lymphatic system?
A. The pigments I use are very vegan, sterile and of the highest quality. Although pigment can be seen in the lymph nodes on an MRI, there are no known negative effects to the lymphatic system as a result of tattoo pigment.

Q. How long does the procedure take?
A. The first session of tattooing is usually 2 hours because this is where the majority of the work is performed. The second session is 8 weeks later and lasts about 45 minutes.

Q. Can you please describe the aftercare regimen (and thanks for the adorable aftercare bag with all of the goodies, love it!)
A. Tegaderm is applied to the tattoos following both sessions.  It is a clear, adhesive bandage that will keep your tattoos, clothes and bedding protected while they heal. The Tegaderm will stay on for 3-5 days. After removing the Tegaderm, you will apply the aftercare lotion that I provide for you to use until the tattoo is healed. It is important to not swim, soak, steam or sweat (I call it all the fun “S”s!) while the Tegaderm is on, and tattoo is healing.

Q. I believe the follow up visit is 8 weeks later? What takes place during this visit?
A. The second session is approximately 8 weeks later and will last about 45 minutes.  During this session, I will reinforce any pigment that might have faded and make any minor adjustments to the new tattoo.

Q. How long should the tattoo last?
After the 2nd session, the tattoo should last a lifetime!

I absolutely love my results and can’t wait to see Marnie and the NYBRA team again in just a few weeks! For more information about NYBRA, check out their website here.

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