The Application of Medical Tattooing in Cosmetic Breast Surgery.

Historically, medical tattooing has mainly been applied to correct or simulate the nipple areola complex among breast cancer survivors postmastectomy. Our purpose was to extend the application of medical tattooing to other cosmetic breast surgeries in a complimentary fashion and to improve aesthetic outcomes through scar blending, areola extension, and/or decorative appliques. Two case studies in which medical tattooing was applied following breast augmentation or reduction are presented. Our clinical procedures are described, including assessment, treatment planning, equipment, inks, and considerations for topical anesthesia. The two cases illustrate the range of applications of medical tattooing in cosmetic breast surgery from minor touch-up, to using elaborate decorative appliques for camouflage. Preoperative photographs, and postoperative patient photographs illustrating good aesthetic outcomes are presented. The field of medical tattooing is effective and is expanding rapidly but needs professional direction. We suggest plastic and cosmetic surgery practices develop active and intentional relationships with professional tattoo artists. Professional medical organizations should lead the development of medical tattoo assistant training and credentialling. Priorities for future research are described.