Looking Beyond the Knife: Establishing a Framework for Micropigmentation following Breast Reconstruction
With the increasing number of breast reconstructions performed annually, we must recognize the shortcomings of an evolving reconstructive landscape and identify further opportunities for advancing the field of plastic surgery. In hopes of building on our institutional reconstructive foundation, we have identified micropigmentation following breast reconstruction to be a critical yet underappreciated component of a comprehensive reconstructive archetype. Currently at our institution, three-dimensional micropigmentation is performed in the clinic setting three times per week. With implementation of on-site tattooing, we establish a necessary foundation for continuity of care within one health system, thus facilitating postoperative follow-up through simplified interaction and enhanced patient experiences.
In addition, in patients who refrain from additional surgery for nipple-areola reconstruction, three-dimensional micropigmentation offers a refined aesthetic result.5 The reconstructive paradigm can be challenging for patients to navigate; thus, offering three-dimensional micropigmentation streamlines postoperative care and offers optimal cosmetic reconstructions in an eloquent and precise manner (Fig. 1). Unfortunately, there is an identifiable gap in accessibility to these services, highlighting the need for more trained specialists to serve the rising demand of patients undergoing reconstruction. To address this recognized concern, the lead micropigmentation expert at our institution has developed opportunities for artists to learn this valuable skill set through designated courses using cutting-edge technology. Ultimately, through best-practice techniques and hands-on mentorship, an efficacious and reproducible rubric emerges to successfully create tattoo “realism” for breast reconstruction patients.
Patients must be afforded every opportunity to achieve a reliable new normal in breast reconstruction. Integration of a micropigmentation specialist within a breast reconstruction center in conjunction with the increased training opportunities in three-dimensional nipple-areola micropigmentation provides an avenue for aesthetic improvement, fosters widespread provider availability, and establishes a reliable and reproducible platform for enhanced breast reconstruction outcomes.