Although nipple areola tattooing is now a well-accepted step in breast
reconstruction, little is known about its long-term effectiveness. A
retrospective study of our 6-year experience in tattooing 151 patients
was thus carried out. Patients were surveyed regarding color match, s
atisfaction, and complications. Follow-up ranged from 1 to 75 months (
mean, 25.2 months). Fifty-seven percent of respondents said their tatt
oo looked similar to the normal areola. There were five (3%) infection
s, one rash, and one slough. Ten percent of tattoos needed a touch-up
later to correct for excessive fading. Nearly 60% of tattoos were ulti
mately lighter than the normal. Eighty-four percent of the tattoos wer
e rated as satisfactory, and 86% of the patients said they would repea
t the procedure if given the same choice again. Nipple-areola tattooin
g done with iron oxide and titanium dioxide pigments thus appears to b
e a reasonably safe and effective procedure in most patients but may r
equire one or more subsequent touch-ups for appropriate color match.