Understanding Breast Numbness When Doing Nipple Tattoos

By PMUHub Editorial Team| Last updated on January 29, 2024
PMUHub contributor areola specialist
⏱️ 5 min read

Written by: Bianca Cypser @areolatattootraining

Nipple & Areola Specialist Bianca Cypser has always been adamant about the importance of knowing anatomy when doing reconstructive tattoos.

As someone who works with cancer patients, she highlights the need for a comprehensive approach, and that starts with knowing the tissue you’re working on.

A breast post-mastectomy and reconstruction can be a challenging canvas, and this includes the level of numbness the patient experiences.

Today, she’s sharing her valuable insights into this topic with the aim to answer any questions about this phenomenon beginner areola tattooists may have, plus advice on how the technique needs to be adapted, because every case is unique.

Anatomy Behind Post-Surgery Breast Numbness

As a specialist with 20 years of experience, I’ve done so many reconstructive nipple and areola tattoos that I’ve encountered just about every level of breast numbness. What I’ve learned is that this phenomenon dictates the way I’ll be performing the tattoo.

Breast numbness after reconstructive surgery arises mainly due to nerve damage or disruption during the procedure.

The skin of the breasts and the underlying tissues contain a dense network of sensory nerves that relay sensations like touch, temperature, and pain.

If these nerves are damaged or severed during surgical procedures, it results in numbness or reduced sensation in the affected areas.

It’s important to understand that the level of breast numbness post-surgery is individual, but getting familiar with different types of breast reconstruction surgery is crucial to knowing how to approach your client.

anatomy behind post-surgery breast numbnessImage source: Instagram @areolatattootraining

2 Types of Breast Reconstruction Surgery

There are 2 main types of breast reconstruction surgeries: implant-based reconstruction and autologous AKA “flap” reconstruction.

Here’s how they affect the level of breast numbness post-surgery.

1. Implant-Based Reconstruction:

Procedure Description: This method uses silicone or saline implants to rebuild the breast.

Numbness Concern: The procedure might involve removing or altering skin, tissue, and some nerves, especially if a mastectomy was performed. The stretching of the skin to accommodate the implant can also affect nerve endings. As a result, numbness is a common side effect.

2. Autologous (Flap) Reconstruction:

Procedure Description: This method uses tissue from another part of the patient’s body, such as the abdomen, back, or thighs, to create a new breast mound.


  • TRAM flap (Transverse Rectus Abdominis Muscle flap): Uses tissue and sometimes part of the underlying rectus muscle from the abdomen.
  • DIEP flap (Deep Inferior Epigastric Perforators flap): Uses abdominal tissue but spares the rectus muscle, which can result in less abdominal weakness post-surgery.
  • Latissimus Dorsi flap: Uses muscle, fat, and skin from the back.

Numbness Concern: Since this procedure involves transferring tissue from one area of the body to another, there’s potential for numbness both at the donor site and the reconstructed breast. The level of numbness might vary depending on which nerves are affected during the tissue transfer.

2 types of breast reconstruction surgeryImage source: Instagram @areolatattootraining

PMUHub Note

Reconstructive tattooing is different from regular permanent makeup, since you’re often working on tissue that has undergone trauma. Therefore, there are a number of ways in which it can look, feel and behave differently from untouched skin.

So if you’re working towards specializing in areola tattooing, or another form of medical tattooing, you need to take the time to study the medical concerns, treatments and procedures that bring clients to you.

It’s a whole other level of micropigmentation and it entails knowing a whole lot about anatomy.

Why the Type of Surgery Matters

Each breast reconstruction procedure presents different challenges concerning numbness.

Flap procedures, for instance, might cause numbness in two areas: the donor site and the breast itself. It also leaves scars in both areas, so the patient may also ask for scar revision or camouflage.

why the type of surgery mattersImage source: Instagram @areolatattootraining

Additionally, the extent of numbness can differ based on the specifics of the surgery, the patient’s healing process, and how many and to what extent the nerves are affected or restored.

It’s important for women to discuss potential side effects, including numbness, with their surgeon before the operation. This conversation can help set realistic expectations and inform post-surgical decisions, like breast reconstruction tattooing.

It’s also important for tattooing specialists to discuss all these factors with the client beforehand. You should obtain as much knowledge about the client’s treatment history as possible so you know what you’re working with.

How the Level of Breast Numbness Determines the Artist’s Approach

Given the variability in numbness based on surgical breast reconstruction methods, it’s crucial for tattoo artists to understand the type of reconstruction a client has undergone.

The tattooing technique might need to be adjusted based on the surgery, the extent of numbness, and any additional complications or considerations.

Tattooing Considerations:

Depending on where scar tissue lies on the breast, tattooing, especially in the nipple area, might present challenges.

The needle could skip on scar tissue, making it difficult to achieve a smooth flow of color. This is a common issue, but there are techniques to address it.

Adjust your tattoo machine to a 4.5 level and use a five-round shader, as this can help ensure a more consistent color flow in the nipple area.

If the needle skips, you can start from the bottom and shade up slowly to work with the scar tissue.

It’s important to work intuitively with the person you’re tattooing, paying attention to how the needles are flowing. If you encounter difficulties, just be patient and continue with a slow whip shading starting at the bottom of the nipple to achieve the desired artwork.

how the level of breast numbness determines the artist's approach

Numbing Cream Considerations:

Determining whether someone needs numbing cream for tattooing isn’t solely based on the type of surgery or scars.

Every woman’s experience with numbness varies, so communication with your client is essential. Ask them if they can feel any sensation in the area you’re tattooing.

Even if a woman claims to be completely numb, there may be moments during the tattooing process where she can feel it.

Stay in constant communication with your client and remain connected to their body intuitively. If something doesn’t feel right, they may make a subtle movement or indication. In such cases, check in with them to ensure their comfort throughout the tattooing process.

numbing cream considerations for nipple tattoo

Final Thoughts

Understanding breast numbing is just one aspect of anatomical implications you have to be aware of when doing nipple and areola tattoos.

The list of physical considerations is extensive and you should devote time and effort into learning as much as possible about them, but as a final word to you – a fellow reconstructive tattoo artist – I’d advise you to always keep the mental and emotional implications in mind.

Your clients come to you for a tattoo, yes, but they’re also looking to get at least a part of the sense of normally back. So never stop working on your chair-side manner, so to say, and do what you can to make the client feel comfortable.



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