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Revised 11/03/26
life after mastectomy
Areola and Nipple Tattoos After Mastectomy
How 3D nipple tattoos are done, who should do them, what they cost, and a conversation with artist Stacie-Rae Weir, who has had a mastectomy herself.
If your nipples were removed with your mastectomy, you have choices about whether, and how, to have them back.
Some women find this last detail matters more than they expected. Some want something they can try on and take off first. Others decide they do not want any further changes. You can take your time deciding what you want.
A nipple and areola tattoo is one of those choices. It can go on a reconstructed breast or a flat chest, and for many women it comes last, after months of surgery, bras and forms. If you are weighing it, this is what it involves, who does it, what it costs, how insurance treats it, and what to ask before you book. Decorative mastectomy tattoos are a different thing, with their own guide.
what is areola and nipple tattooing?
A nipple and areola tattoo puts the look of a nipple and areola back on the breast after mastectomy. It can follow reconstruction with implants or with your own tissue, with or without nipple reconstruction,1 and it can also be done if you went flat.2 If a surgeon rebuilt a nipple for you, the tattoo adds color to it and creates the areola around it. If not, a 3D tattoo uses shading to make a flat area look raised. It looks like a nipple and feels like flat skin.1 Doing it well takes real skill, because scar tissue takes pigment differently from healthy skin, and the color, size and placement all have to suit you.
Two kinds of people do this work: staff in a plastic surgeon’s office or hospital, often a physician assistant,3, 4 and tattoo artists who specialize in restorative work. Stacie-Rae Weir, who founded Areola Restorative Tattooing (A.R.T.), treats areola tattooing as art as much as medicine.
a surgeon’s office or a tattoo artist?
Both are options, and neither is automatically better. A plastic surgeon’s office or hospital can usually file the insurance claim for you; with an independent artist, you may file it yourself.2 Some hospitals have staff with special tattoo training. At Memorial Sloan Kettering, for example, the tattoos are done by physician assistants and nurse practitioners with special training and a tattoo license.5 Specialty tattoo artists spend their days on realism and on scar tissue.6 Compare the practitioner’s training, experience with scars, and healed results.
Healed results matter more than fresh ones. A fresh tattoo can look darker than it will after healing, and what you will live with is how it looks a few months later, so ask to see that.
Questions to ask before you book. Screenshot this list or print the page to take to your consultation.
- Ask how many areola tattoos they have done
- Ask to see photos of healed work on reconstructed breasts, not just fresh results
- Ask how they were trained to tattoo scar tissue
- Ask how they will match your skin tone, and whether they test the color on your skin first
- Ask whether the touch-up session is included in the price
- Ask whether they bill your insurance, or whether you will file the claim yourself
- Ask what happens if you are not happy with the color or shape
Looking for someone near you? The nonprofit P.ink keeps a directory of tattoo artists with mastectomy experience, where you can browse each artist’s portfolio.
what to expect
from booking to healing
before you book
let your chest heal
Your chest needs time to heal and settle into its final shape after your last surgery, whether that was breast reconstruction, a flat closure or nipple reconstruction. How long varies: Breastcancer.org suggests at least three to four months, and if you are going to a tattoo studio, getting your plastic surgeon’s OK first.2 Memorial Sloan Kettering waits about a year after the final reconstruction surgery.5 Your surgeon and your practitioner will tell you when your skin is ready.
the appointment
design and color matching
Plan on about two hours. You and the practitioner talk about what you want the nipple and areola to look like, where they should sit, and what color would look most natural with your skin tone. Then they mix the ink until you both like the color, matching your natural nipple as closely as possible if you still have one.5 If you have a photo from before surgery and would like to use it as a reference, bring it.2
during
does it hurt?
Usually not much. It’s common to lose feeling in the breast after mastectomy, so most women feel only pressure or vibration. Numbing cream is available, but it can affect the color of the tattoo, so some practitioners suggest it only if you need it.5 If you have implants, the tattoo pigment is placed within the skin itself, above the implant, which sits beneath deeper layers of tissue.7
first 7 to 10 days
your options compared
surgery, tattoos and stick-on nipples
There is more than one way to have a nipple again, and you can combine them, such as surgery followed by tattooing. You can also choose none of them. There is no medical reason to reconstruct the nipple just because you had breast reconstruction.1
| Option | What it is | Raised to the touch? | How long it lasts |
|---|---|---|---|
| Nipple reconstruction surgery | A surgeon shapes a new nipple from the skin of the reconstructed breast. It usually doesn’t have the feeling of a natural nipple. | Yes, though some flattening is common over time. | Permanent.1 |
| Permanent 3D tattoo | Shading and highlights make a flat area look like a raised nipple. | No, it is flat. | Permanent, but the color fades and may need a touch-up.1 |
| Temporary nipple tattoo | A transfer you apply with a wet cloth. | No, it is flat. | Usually a week or two, depending on the brand. Remove it as the maker directs.8 |
| Stick-on silicone nipple | A removable silicone nipple that sticks to the skin. | Yes, it is a molded silicone nipple. | Reusable. Put it on and take it off whenever you like.1 |
Not ready for a tattoo, or not sure you want one? The Amoena Adhesive Nipple Set is a silicone nipple that sticks on and comes off, so you can see how you feel about having one before you decide anything permanent.
interview with Stacie-Rae Weir
tattoo artist, founder of A.R.T., and a mastectomy patient herself
We talked with Stacie-Rae in 2018. By then she had been tattooing for 20 years, and she had had a mastectomy herself. Based in Calgary, Alberta, she developed her own method for realistic 3D nipple tattoos and trains other artists in it. Her answers below are from that conversation, as she gave them, with a few typos fixed.
Headcovers: What originally got you interested in nipple and areola tattoos?
Stacie-Rae: I had been tattooing for 15 years when cancer came into my life. I was excited at what tattooing could do for people who have gone through so much trauma. I was also excited at a new challenge and a chance to “use my powers for good instead of ‘evil’” hehehe. I was looking for a challenge, and this is the most challenging work I’ve ever done.
Headcovers: One thing that sets you apart from other tattoo artists or surgeons who perform areola and nipple tattoos is that you have actually had a prophylactic bilateral mastectomy, so you understand how it feels to go through this process. What piece of advice would you give to women about to undergo surgery or considering an areola tattoo?
Stacie-Rae: Yes, I have had a mastectomy and know firsthand how horrible it is to have your chest torn apart and left scarred. We try so hard to downplay how terrifying it actually is, and most tattooists have no idea what their clients have actually faced. I have a lot of women asking for advice but it really comes down to: do what feels right for you. We know what’s right for us, deep down inside. The trick is to trust our gut and stop second-guessing ourselves. Either way you approach a mastectomy, it’s no party!
Headcovers: How long does the areola tattoo process take from first consultation to final session?
Stacie-Rae: First, the scars need ample time to mature. If they are tattooed before they are ready, a practitioner can unknowingly cause so much damage that delicate tissue may never hold pigment again. Once we know the scars are in great shape, I will see a person 2-3 times in 10 weeks. My nipple tattoos are permanent, so after that I just want my clients to go out and love their lives!
Headcovers: What was the most creative mastectomy tattoo you have done?
Stacie-Rae: I don’t know how to answer that, my clients have such great ideas! There was one big octopus that I loved doing. I made it very pretty. They’re all unique and beautiful, but a scar will never fully disappear. So, to cover it effectively, you need to almost create an optical illusion that carries your eye past the scar. A clever flow that flatters the body is key. The worst thing to do is just stick a design right ON the scar line, bringing your attention straight to it. Especially since scar tissue will not hold color as well as healthy tissue, leaving behind inconsistencies over the damaged areas. The composition must leave room for that.
Headcovers: What is your most memorable experience with a patient?
Stacie-Rae: All my clients leave a beautiful impression. I learn from each person I tattoo, and we share a powerful connection in this intimate and life-changing work. I honestly can’t say any one stands out any more than any others. They all mean so much to me, even if they don’t realize it.
Headcovers: You seem to do it all! Not only are you an author, speaker, and tattoo artist, you are also involved in P-Ink.org and the founder of A.R.T. (Areola Restorative Tattooing). What obstacles have you faced since becoming the founder of A.R.T.?
Stacie-Rae: A.R.T. puts art first, which was previously the missing element to great nipple/areola tattoos, to inspire tattooists to realism, rather than a simple pink or brown circle. I’d say we accomplished that goal, as there has been a higher standard of nipple tattooing enjoyed world-wide. If a nipple looks like it’s a tattoo, that survivor may not reach the mind-body-spirit connection required to fully heal. But if it is a tattoo that looks like a nipple, just natural like a real nipple/areola complex, then she will feel free to enjoy her life like nothing has ever been taken away.
With change comes resistance, though. The medical field is a little slower to catch up, and still using archaic practices like using circle templates and outlining nipples! No nipple looks like that in real life. Unfortunately, the survivors trust the medical field for tattooing still, even though under-skilled practitioners are harming survivors by executing terrible nipple tattoos over beautiful breast reconstructions. This really gets me upset, with so many better options available simply by working with a highly-skilled specialty tattooist. It’s time that the medical field outsourced to A.R.T. certified artists and other proven specialists.
The sad truth that no one really wants to talk about is that most medical and cosmetic tattoo practitioners doing areola tattooing have taken just a 1-day course and barely know how to use a tattoo machine. They do not know how to draw and they do not understand how to tattoo scar tissue. The survivor is unknowingly being practiced on by someone who doesn’t know how much they don’t know, it’s an epidemic, and we have to question the ethics of it. We feel that survivors deserve better!
Headcovers: With so many amazing projects, what do you do in your free time?
Stacie-Rae: I always make time to ride my horse, and I barrel race semi-professionally in my ‘spare time’. I think we all need something that makes us stoked to be alive! Barrel racing is an adrenaline rush, it feels like flying. I encourage everyone to embrace whatever gets your heart going.
Also, I love mentoring other experienced tattooists to realize their own greatness by helping them fine tune their skills. We’re all here to do our absolute best work for the survivors, right?
Headcovers: What other information would you like to give women with breast cancer?
Stacie-Rae: You deserve the best!! After everything you’ve been through, do NOT settle for a tattoo that is less than amazing. This is your chance to finalize your journey, so choose a great artist that understands how important this is!
Do what feels right for you. We know what’s right for us, deep down inside. The trick is to trust our gut and stop second-guessing ourselves.Stacie-Rae Weir
see real results
photos on trusted sites
You can see examples of nipple and areola tattoos in these two galleries.
Please note: each gallery includes close-up photographs of reconstructed breasts with nipple and areola tattoos.
- Stacie-Rae Weir’s gallery: a specialist artist’s portfolio of 3D areola tattoos.
- Memorial Sloan Kettering Cancer Center: tattoos done by the hospital’s own trained staff, on its own patients, shared with their permission.
for every stage after mastectomy
our most popular picks
Amoena Adhesive Nipple Set
A realistic silicone nipple that sticks on. No needles, nothing permanent.
shop →Amoena Mara Bra
Our most popular mastectomy bra, a padded, wire-free T-shirt bra with pockets.
shop →ABC 909 Seamless Triangle Puff
Our best-selling breast form, a light, adjustable fiber-fill triangle with a soft seamless cover.
shop →Amoena Essential Light 2S
Our most popular silicone form, about 25% lighter than standard silicone, and shaped to fit either side.
shop →See all mastectomy bras, breast forms, or everything for mastectomy.
questions and answers
before you book your areola tattoo
when can I get nipple tattoos after reconstruction?
Nipple and areola tattooing is usually the last step of breast reconstruction, after any nipple reconstruction surgery, or in place of it.9 If you have tissue expanders now, that means waiting until your implants are in and your surgeon says your reconstruction is complete. Guidance on timing ranges from at least three to four months after your last surgery2 to about a year after your final reconstruction surgery.5 If you are going to a tattoo studio, get your plastic surgeon’s OK first.2
Your scars also need time to mature first. Your surgeon and your tattoo artist can tell you when your skin is ready.
does insurance cover nipple tattoos?
Usually, yes. In the United States, health plans subject to the Women’s Health and Cancer Rights Act that cover mastectomy must also cover nipple and areola reconstruction, including repigmentation, which is the tattooing. Your plan’s usual deductible and coinsurance can still apply.10 Some plans, including Medicare, may cover nipple and areola tattooing under certain conditions.5 Medicaid coverage varies by state.2
What varies is whether a particular practitioner is covered. Before you book, ask your insurer whether your chosen practitioner is eligible, whether you need prior authorization, and what you will pay. If you go to an independent studio, you usually file the claim yourself, with the artist’s receipt and a prescription from your plastic surgeon.2
what if insurance denies my claim?
You can appeal. Ask your practitioner or your surgeon’s office which billing codes they used. One Blue Cross policy lists nipple and areola tattooing under CPT codes 11920, 11921 and 11922.11 Then follow your insurer’s appeal process, and ask your surgeon for a letter explaining why the tattoo is part of your reconstruction. The nonprofit FORCE offers free sample appeal letters for breast reconstruction that you can adapt.12 If your insurer turns down every internal appeal, check the denial letter for any right to an independent external review and the deadline for requesting it.12
how much do areola tattoos cost?
Prices vary by practitioner and region. Breastcancer.org puts a typical price from an experienced artist at about $350 for one nipple and $600 to $800 for two, more if the artist travels to your area.2 Hospital programs are another example. Woman’s Hospital in Baton Rouge lists $400 for one side and $500 for both.13 Ask whether the price includes the consultation and the touch-up session.
If cost is a barrier, ask about discounts. Some artists set aside days for free nipple tattoos, and several nonprofits offer grants to help cover the cost.2 Stacie-Rae offers a free areola tattoo clinic in Calgary; contact her to ask about eligibility and availability.14
what if I don’t want a nipple tattoo?
Then you don’t need one. There is no medical need to recreate the nipple, and many women choose not to.1 If you would like the look of a nipple without a tattoo, a stick-on silicone nipple is a removable option. The Amoena Adhesive Nipple Set is a realistic silicone nipple that sticks on, with no needles and nothing permanent. It is also a way to see how you feel about having a nipple before you decide on a tattoo. Amoena’s self-sticking nipples come in four colors and three sizes, and some insurance plans cover prosthetic nipples with a prescription or letter from your doctor.2
how do I find a qualified areola tattoo artist?
Look for an artist trained specifically in areola work and in tattooing scar tissue. Stacie-Rae’s A.R.T. program certifies artists in her method, and her website is a good place to start.14 The nonprofit P.ink also keeps a directory of artists with mastectomy experience.15 Before you book, ask to see healed work on reconstructed breasts. Breastcancer.org also keeps a list of recommended specialists across the US.2
does a nipple tattoo hurt?
Most women say no, or not much. Feeling in the breast is often reduced after mastectomy, so what most notice is pressure or vibration. Numbing cream is available, but it can affect the color, so ask your practitioner whether you need it.5
can the tattoo needle damage my implant?
It is not expected to. Tattoo pigment is placed within the skin itself, above the implant, which sits beneath deeper layers of tissue. If you have any concerns, ask your plastic surgeon before you book.7
can I get nipple tattoos after radiation?
can I get nipple tattoos if I went flat?
Yes. Nipple tattoos are usually done after reconstruction, but they can also be done after an aesthetic flat closure.2 Some women who go flat prefer a decorative mastectomy tattoo instead.
what if I still have one natural nipple?
what if I don’t like how my tattoo looks?
Tell your practitioner. Color and detail can often be adjusted at the touch-up session, and more tattooing can be arranged later to adjust the tone.7 If your tattoo was done somewhere else, ask a restorative tattoo specialist whether they correct other practitioners’ work, and ask to see examples before you book.
a note from our founder
I had a preventive double mastectomy. My surgeon was able to save my nipples, and I know how lucky that was. Many of the women we talk to every day did not have that choice.
That is why this page exists. Not to tell you what to do, but to make sure that if you want them back in some form, you know what is possible, what it costs, and who to trust.
If you have a question we did not answer, or you have been through this and want to tell us what would have helped, write to us through our contact page. That is how this guide gets better.
Danielle
Comfort for every stage after mastectomy.
Pocketed bras and breast forms from Amoena, ABC, Trulife and more.
keep learning
mastectomy tattoo ideas21 designs that turn mastectomy scars into art.
breast cancer tattoo ideasRibbon tattoos and other ideas for survivors.
going flatWhy one woman chose not to reconstruct.
how to dress after mastectomyClothes that feel good while you heal.
mastectomy bra buying guideHow to choose and fit a pocketed bra.
breast form buying guideHow to choose the right breast form.
- Mayo Clinic, Nipple Reconstruction. ↩
- Breastcancer.org, 3D Nipple Tattoos. ↩
- Memorial Sloan Kettering Cancer Center, Nipple and Areola Tattoos After Breast Cancer Surgery. ↩
- Nipple-areola tattooing and insurance coverage under the Women’s Health and Cancer Rights Act (PubMed Central PMC6908362). ↩
- Memorial Sloan Kettering Cancer Center, About Your Nipple and Areola Tattoo Procedure. ↩
- KUAF (NPR), Trying to Solve Problems With Insurance, Tattoo Artists and Breast Cancer Survivors. ↩
- The Dudley Group NHS Foundation Trust, Medical Tattoos After Breast Surgery. ↩
- WebMD, Nipple and Areola Reconstruction and Tattoos. ↩
- Canadian Breast Cancer Network, 3D Nipple and Areola Tattoos 101. ↩
- U.S. Department of Labor, FAQs About Affordable Care Act Implementation Part 31 and Women’s Health and Cancer Rights Act Implementation. ↩
- Blue Cross & Blue Shield of Rhode Island, Breast Reconstruction and Applicable Mandate (medical policy). ↩
- FORCE (Facing Our Risk of Cancer Empowered), Filing an Appeal. ↩
- Woman’s Hospital, Areola Tattoo. ↩
- Stacie-Rae Weir, stacie-rae.com. ↩
- P.ink (Personal Ink), artist directory. ↩
All sources last checked November 2026.
This guide is for informational purposes only. It does not replace advice from your physician. If you have questions about your specific situation, please consult your care team.
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