Not everyone who undergoes either FTM or FTN top surgery wants their nipple-areola complexes (“nipples” for short) surgically replaced and there are many reasons for this choice. Electing to have no nipples is definitely an option when undergoing either a double incision mastectomy or the inverted “T” approach. It is not a realistic choice with the keyhole or concentric circle/periareolar techniques.
Seeking gender affirming top surgery without nipples is far more commonly requested by gender nonbinary individuals (FTN) as compared to transmen (FTM). This likely should not be very surprising.
Most of those seeking nippleless FTN or FTM top surgery just want to have a flat chest – and no more. There are, however, some individuals who choose not to have their own nipples put back on but do want to have nipples tattooed on their chest sometime in the future.
For these individuals (and some others – see below), 3D tattooed nipples are an excellent, state of the art option.
What is 3D Nipple Tattooing?
3D (3 Dimensional) nipple tattooing is the technique by which different shades and colors of pigments are utilized in order to simulate a 3-dimensional appearing nipple-areola complex on the chest. The results can easily be customized for each individual. This include such factors as color, shades, size, shape and location on the chest.
The initial application of this technique was to re-create a more normal appearing tattooed nipple-areola complex in breast reconstruction secondary to breast cancer. Its uses have since been expanded to include gender affirming top surgery.
The photo below demonstrates one example of 3D tattooing of nipples following top surgery. This appears to be 3 dimensional but it actually is flat – 2 dimensional.
Tattooed nipple-areola
Indications for 3D Nipple Tattooing
Why after undergoing either FTN or FTM top surgery would you want to have nipples tattooed on your chest? The following are the most common reasons for this decision:
- You detest your own nipples but want to have nipples on your chest. Some individuals have dysphoria not only of their breasts, in general, but also specifically of their own nipples. However, they do ultimately want to have nipples on their chest after top surgery. 3D tattooing is the perfect solution.
- You want to have complete control over the process including size, color, shape and location. Some individuals know that they want to have nipples after top surgery but want to have complete control/decision making over the process. Pursuing the tattoo approach rather than having one’s own nipples placed back on again is the ideal solution for this.
- You have changed your mind about not having nipples after undergoing top surgery without nipples. Initially, you decided to have FTN/FTM top surgery without nipples. However, at some point afterwards, you have decided that you like having a flat chest but do really want to have nipples now. Having nipples tattooed on to address this preference is an easy, non-surgical solution.
- There was partial or totally failure of healing of the nipple-areola complex grafts after top surgery. For whatever reason, the nipple-areolar grafts for your mastectomy did not heal well or at all. It/they are distorted or are now just scar tissue. Reconstructing them by 3D tattooing offers a reasonable solution to address this issue.
- You are afraid of having failed grafts after top surgery. You might have heard or read online about failures of nipple grafts or related “horror” stories and just don’t want to either take the chance of this happening or have to deal with the consequences yet you do want nipples. Having them tattooed later on clearly solves this problem.
Where Should You Go For Your 3D Nipple Tattooing?
In order to have a high likelihood of obtaining the results that you want for 3D tattooing of your nipples, you should go to someone who is well-trained and experienced in performing this procedure. Depending on where you live, however, there may be limited or even no local options.
Your local generic tattoo artist down the street or set up in a strip mall is definitely not the place to be looking to have this done. Hopefully, they wouldn’t agree to do it even if you asked.
Instead, you should seek out a licensed, experienced individual who performs medical and cosmetic tattoos and specifically is trained to do 3D nipple tattoos. The plastic surgeon who performed your top surgery may be able to provide you with some recommendations. Online research can also be helpful.
How Soon After My Top Surgery Can I Have Nipples Tattooed on My Chest?
There is no one correct answer as to when is the earliest time, after undergoing either FTN or FTM top surgery, that you can have nipples tattooed on your chest. This will depend on a variety of factors including surgeon recommendations, post-surgical healing and even tattoo provider preferences.
In general, most recommendations range from around 3 to 6 months after having top surgery with the longer time frame more common.
Will Insurance Cover Nipple Tattooing?
Presently, some insurance plans may authorize coverage for 3D nipple tattooing.
Possibly. But don’t count on it. In addition, the practitioner who would be performing the tattoo must be in the medical field.
More likely, you will need to pay for this on your own – so be prepared. Furthermore, the cost to have this done varies over a very wide range with some practitioners charging thousands of dollars.
You will definitely want to do your research both on results and costs.
Your Consultation
If you are interested in pursuing FTM or FTN gender affirming top surgery or are wanting more information on 3D nipple tattooing, please call the Arizona Center for Aesthetic Plastic Surgery at (480) 451-3000 or contact us by email.
Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona
