Information for patients
This leaflet is intended for patients who have undergone breast surgery with reconstruction and answers common questions about micro-pigmentation (medical tattooing). If you would like further information, or have any particular worries, please do not hesitate to ask your nurse or doctor.
In all cases, your practitioner will explain the procedure to you and answer any questions you may have.
In most cases it will be possible for a friend or relative to accompany you for all or part of the procedure. Please ask your practitioner.
What is micro-pigmentation?
Micro-pigmentation is the process of inserting pigments into the dermis layer of the skin, similar to tattooing, to create a natural appearing breast after reconstruction.
Micro-pigmentation is semi-permanent and the intensity of the colour is usually achieved in two to three episodes. Your practitioner will advise if further appointments are required. You will receive a clinic letter after each appointment.
Factors which may affect the outcome

  • sun damaged skin, dry or oily skin, thickness of skin, scar tissue, skin colour
  •  pH of skin (acidity)
  •  alcohol
  • smoking
  • illness

medication
Are there any risks?

  • Risks are minimal but may include:
  •  not achieving an accurate colour match
  •  potential risk of wound infection and scarring
  •  pigment migrating (pigment may move into surrounding skin)

uneven pigment colour
some discomfort during the procedure, but this is minimised with topical local anaesthetic
The equipment
The micro-pigmentation machine meets health and safety regulations and all needle cartridges are sterile and disposed of after each individual procedure.
Before the procedure
A skin allergy test may be advised at least 24 hours before the procedure, to detect reaction to the pigment or any topical anaesthetic if used.
The procedure
Each clinic appointment is scheduled for 60 minutes. During this time your practitioner will ask you some questions and help in deciding upon the size of areola and nipple, and pigment colour. You will be given a gown to put on and the procedure is carried out while you are lying down on the treatment couch. Small amounts of pigment are then implanted into the skin with the tattoo machine handset. The length of time needed to complete the procedure will depend on size of the area to be tattooed, depth of colour and compatibility of the pigment with the skin type.
You may experience some redness, slight swelling or discomfort after the procedure. These symptoms usually subside within a few days. Please contact your practitioner if these symptoms do not subside.
After care advice
After the procedure, a light dressing will be applied. You may remove the dressing yourself the next day before taking a shower or bath. Your practitioner will give you a couple of spare dressings to protect your clothing and underwear from tattoo pigment until it is dry.
You may apply Vaseline® for a few days after the procedure, before bathing or showering, to allow water to bead off the tattoo.
Avoid soap, sunbathing, swimming, saunas and jacuzzis for a week after the procedure.
You can expect the pigment to fade by 40-50% as the colour softens.
Is there an alternative to micro-pigmentation?
If you do not wish to have micro-pigmentation, please discuss this with your doctor or nurse. The alternative to micro-pigmentation would be to seek
opinion from a tattoo artist or consider a stick-on prosthesis, obtainable from the surgical appliances department.
Consent
Before carrying out any procedure or treatment, we will seek your consent. Staff will explain the procedure or treatment to you, along with the associated risks, benefits and alternatives before they ask you for your consent. If you have any questions about your care, or any concerns, please do not hesitate to ask for more information.
Useful contacts
Plastic surgery out-patient clinic 4: 020 7794 0500 ext 31312
If you would like a large print or audio version of this information, please ask a member of staff.
© Plastic and reconstructive surgery department
Version number: 2
Approval date: February 2016
Review date: February 2018
www.royalfree.nhs.uk