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Rethinking NAC Tattoo - A New Technique with Superior Results
Eric G. Halvorson, MD1, Michael Cormican, MD2, Misti E. West, RN3, Vinnie Myers4.
1Harvard Medical School, Boston, MA, USA, 2Emory University, Atlanta, GA, USA, 3MD Anderson Cancer Center, The Woodlands, TX, USA, 4Little Vinnie's Tattoos, Finksburg, MD, USA.
INTRODUCTION
We present a new technique for tattoo-only nipple-areola complex (NAC) reconstruction that offers aesthetically superior results and has led to an increase in the number of women choosing tattoo-only NAC reconstruction in our practice. This technique was developed by tattoo artist Vinnie Meyers.
METHODS
Patients undergoing NAC reconstruction from January 2009 through July 2011 were reviewed. This timeframe provided equal time periods before and after the introduction of the new technique.
TECHNIQUE
The technique is essentially the inverse of commonly performed NAC tattoo. The areola is created according to patient preference in diameter and color. Instead of a darker inner circle to create the appearance of a nipple (Fig. 1), a lighter circle is created with a dark border (Fig. 2). For patients who undergo surgical nipple reconstruction, only the areola is tattooed (Fig. 3).
RESULTS
From January 2009 to April 2010, 81 women underwent NAC reconstruction at our hospital. Twenty-six (32%) chose tattoo-only and 55 (68%) chose surgical NAC reconstruction. From April 2010 to July 2011, 122 women underwent NAC reconstruction. Fifty-nine (48%) chose tattoo-only and 63 (52%) chose surgical NAC reconstruction. A 52% increase in patients choosing tattoo-only NAC reconstruction was noted. The number of breast and plastic surgeons remained constant throughout the study period.
DISCUSSION
Traditional coloring techniques for NAC tattoo ignore the artistic principles of light and shadow to create depth on a two-dimensional surface. The technique presented results in a more realistic and three-dimensional reconstruction that can look better than surgical NAC reconstruction and standard tattoo. Although results obtained by nurses using standard medical tattoo equipment are not as good as those obtained by a professional tattoo artist (Fig. 4), patient satisfaction has been very high.
   
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