No, it is not a surgery. Micropigmentation is a minimally invasive procedure. Infact one can say it is a finer and refined form of a cosmetic tattoo. The pigments and instruments used may differ from a conventional tattoo. Also, instantly after the procedure, you are ready to go and get back to your normal routine.

Patients with loss of the nipple and areola from cancer excision, trauma, or congenital absence continue to experience psychological distress even long after breast mound reconstruction has taken place. Other conditions requiring nipple areolar complex (NAC) reconstruction include congenital or developmental pathology (athelia, amastia), post-traumatic or burn deformities, and complications from breast surgery such as reduction mammaplasty. NAC can also benefit patients cosmetically, once a patient has undergone a Mastopexy (breast uplift surgery) the Areola can be left misshaped or with scarring surrounding it. Pigment can be added to an Areola to improve the appearance of the surgery outcomes. Patients with stable areola vitiligo also benefit from the procedure.

Although various surgical techniques are available for the reconstruction of both the nipple and the areola, the final color of the NAC is rarely close to that of the contralateral breast, except when the nipple is grafted from the opposite breast. Micropigmentation is a simple, comparatively low-cost, out patient procedure that does not cause morbidity of any donor areas and shows a low rate of complications as compared to other surgical options.

A medical/ paramedical or a micropigmentation professional with a suitable training can offer you this treatment. Please note that it is important to have a high level of hygiene at the place of procedure to avoid any untoward health complications. Also the service provider must know of and practice the universal precautions and risk reduction to avoid any transmittance of Blood Borne Pathogens.

Before the procedure:

In the first consultation, physician/service provider would take proper history and evaluate the scope of micropigmentation after examining in privacy, the areas to be worked upon. Also in this consultation, the placement, shape and colour of the pigments can be finalized. The service provider may do a test patch with the chosen colour and the numbing cream to check for any allergy. Only after one day of such test, if your body is not allergic to any of two, an appointment for the procedure shall be given. You may be asked to discontinue some medication/ supplements/ alcohol etc for sometime before the procedure.

During the procedure:

After the effect of numbing cream takes over, the patient is escorted to the procedure room, where the process of micropigmentation takes place under hygienic and aseptic conditions. This may take 2 hours or so. You may listen to your favorite music meanwhile.

After the procedure:

After the procedure, you shall be advised about the post procedure care for next few days, till the area has healed properly. You shall also be given a date for the touch-up session.

Initial consultation, Physical examination, aesthetic evaluation and assessment along with a mock-up drawing requires around 30 -45 min. The procedure itself may take 2 hours. The touch-up session after 4-6 weeks may require 1-2 hours.

Nipple reconstruction is usually delayed for several months after breast mound reconstruction to allow the new breast time to settle. Location of the procedure is determined by the contralateral breast.

The skin can be tattooed before or after nipple preparation, depending on the surgeon’s preference. A minimum gap of 6 to 12 weeks must be observed when this procedure is performed after reconstruction in order to allow the nipple to stabilize and contract.

The micropigmentation can be performed both on reconstructed NAC or without it. In both the cases, micropigmentation by virtue of closely matched pigmentation with the contralateral side helps in enhancing the appearance of breast and as many patients have reported that it gives them satisfaction and happiness.

Nipple tattooing is a technique initially developed by plastic surgeons. It was first described in 1975. Today the use of micropigmentation to complete breast reconstruction by recreating the NAC is well documented. It is a safe and effective technique. Scientific papers have reported a minimal prevalence of skin reactions to titanium dioxide and ferrous oxide pigments, stating that NAC tattooing with these components is completely safe in patients with healthy skin.

Allergy test: You will be offered a skin patch test 24 hours 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 anesthetic and pigments used during the procedure. A full 24 hours is needed after the skin test to see if allergies occur.

The pigment stays strong for 3 to 5 years, and may require touch up later. As for maintenance, it’s important to avoid exfoliates and unprotected sun exposure which will rapidly fade the color.

Micropigmentation specialists use topical anesthetics to control pain. Properly trained and certified professionals use numbing agents before the procedure begins and then again during the procedure to minimize discomfort. Also, due to nerve damage subsequent to the surgery the canvas for micropigmentation artist is often numb and also since it is not directly over a bone the chances of pain reduce further. It is said its 3 on 10 on pain score.

A safely performed, micropigmentation procedure along with the use of quality products and practicing universal precautions is a very safe procedure.

The main risks may include:

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

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.

Some pigment colours contain a trace of iron oxide. If you have a CT or MRI scan, you

will need to tell the scanning technician about your miropigmentation so that they can assess the risk of side-effects as there have been reports of burns/tingling to the micropigmented  area.

Under the Bud In the Nip initiative of Dermakraft, the service of NAC restoration for Breast cancer survivors is offered at highly subsidized prices. The subsidy to the tune of 70% brings down the cost of the restorative procedure to Rs 8,500  for unilateral restoration and Rs. 15,000 for bilateral restoration. Keeping up with the vision of the project, there is no compromise in quality or aesthetic outcomes; at any level. The project is able to support the subsidy for Breast cancer survivors from:
1. Project’s own income from other micropigmentation related procedures.
2. Support from various units of Dermakraft.
3. Donations from well-wishers.