Areola - Case 1

by Andrea Darby - Master Medical Tattooist & Industry Educator
Areola Case 1 - Before

In this BEFORE photo the client had bilateral prophylactic mastectomy without nipple sparing and wanted to restore the appearance of her Nipple Areola Complex with tattooing rather than a surgical nipple recontruction. ...
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Areola (Case 1)

Client Information

Intro: Our case studies are the perfect way to gain a deeper insight into the products required to provide a particular type of service.

This client opted for bilateral prophylactic mastectomy (without nipple sparing) due to a strong family history of breast cancer.

Fitzpatrick Skin Type: II
Hair Colour: Blonde
Grey Light Blond Blond Strawberry Blond Red Light Brown Medium Brown Dark Brown Black

Before Photo

After Photo - (healed 6 weeks after first procedure)

Click for Larger Image

Comments: Collagen Induction Therapy (CIT) of surrounding scar tissue/graft is an optional service to increase natural skin colour in scar tissue and grafts which can be performed at the time of NAC Tattooing or during follow up treatments at the choice of the client, some clients prefer to evaluate the outcome of Nipple Areola Complex Tattooing prior to opting for additional services such as CIT/dermal needling.

We see a lot of examples of incorrect NAC positioning and sizing taking place often this is due to lack of guidance on these steps when performing Areola Tattooing during training programs.

Sizing the NAC Tattoo

Our 3D-SAT Workbook covers this topic in detail.

Our Technicians Workbook describes how taking 3 measurements will help technicians locate the midpoint of the breast and will also provide some guidance on the suggested size range and position for the new NAC in situations where there is no remaining natural areola and no surgical reconstruction of the areola has been performed.

In the example diagram above taken from our 3D-SAT Workbook I describe how for example a breast circumferential measurement of 28cm multiplied by our sizing ratio's of 0.09 & 0.13 provides a suggested NAC complex diameter rage of 2.52cm - 3.64cm which can be approximated with an Areola Circle Template.

Further details on recommended NAC Complex positioning and sizing can be found in our;
3D Simulative Areola Tattooing (3D-SAT) Workbook.

Equipment & Products

 Procedural Consumables

Often technicians claim to be using 'sterile technique' or 'aseptic technique' for a cosmetic tattoo service when in fact the products being use are not of those standards. Aseptic technique involves the compliance with specific standards, the use of a particular grade of consumable supplies and the use of hygiene barriers wherever possible. For example a procedure can hardly be claimed to be 'aseptic technique' if un-sterile gloves or un-sterile gauze are used during a service to wipe tattooed skin or if food handling protective equipment is used instead of the appropriate use of Personal Protective Equipment (PPE) as recommended by health authorities.

If a cosmetic tattoo store is offering food handling mouth shields for sale it is a fair indication that they do not understand the difference between the kind of PPE required for Cosmetic Tattooing to protect the client and the technician vs. those used in the food industry.

For this reason I recommend that technicians are not misled into purchasing products that are inappropriate for use during a skin penetration service by suppliers who do not hold the necessary qualifications to make these kinds of recommendations, ideally this kind of advice is provided by a supervising Registered Health Professional.

 Amiea Microprocessor Controlled Digital Machines

Any serious full time cosmetic tattooist will have 2-3 or more devices to choose from when providing client services and at least 2 hand pieces for each device, leading technicians and educators such as myself will often have 5-10 devices that are all used for different purposes. Most of us will have a go-to device that is our day to day workhorse for the majority of procedures and mine is the Amiea Linelle Supreme I have used them all at one time or another over the years and the Linelle Supreme always comes out at top of the list.

Needle Profiles:

 Creatips for Amiea Linelle Supreme


 Amiea Pigments

Main Body of Areola

  • Amiea Organic - Areola 550
  • Amiea Organic - Pomegranate

NAC Margins

  • Amiea Organic - Pomegranate


  • Amiea Organic - Areola 550
  • Amiea Organic - Brick Red


  • Amiea Organic - Camo 510

Many Cosmetic Tattoo Technicians seem completely unaware of the legal requirements related to manufacturing or importation of pigments into Australia, a recent survey by our Chemical Regulator the Australian Industrial Chemicals Introduction Scheme "AICIS" formerly known as "NICNAS" highlighted that many pigments currently on the market may not be compliant.

Before purchasing any cosmetic tattoo pigment always insist that the supplier provides written confirmation that they are registered with AICIS and that they have audited their pigment for compliance with Australian Regulations and they hold product liability insurance, if not you may be taking an enormous risk.

The European Commission have tasked their chemicals advisory body ECHA with recommending restrictions on the use of a wide range of chemicals that are currently in use by tattoo pigment manufacturers and the European Community are due to vote on the proposed restrictions in 2019. Some of the Medical Professional Associations have publicly stated that even these proposed new restrictions do not go far enough. Our expert opinion is that much stricter regulations will occur in the EU and these standards will eventually be adopted in many other countries.

Some pigment suppliers seem to be totally oblivious to their obligations under the law or the changes that are taking place around the world related to the health and safety of tattoo pigments. In addition to the strict manufacturing standards followed by the PhD chemists at Amiea we independently audit the pigments that we supply for compliance and I recommend that our customers consider carefully the differences between Amiea and alternative brands before making any pigment purchases.

You may find our Amiea Pigment Colour Selection Interactive  & User Tips are helpful for learning about the Amiea pigment range and for choosing pigments for your client.


Specialised needle techniques were utilised for this service which are described in detail during our 3D-SAT - Training Course.

However many cosmetic tattoo technicians who are intending in enrolling in our training course have purchased our 3D-SAT Workbook for pre-reading.

Whilst I am prepared to provide information about equipment and products used for our Case studies free of charge, information about specific techniques are taught during our training sessions and sometimes contained within our various publications that are available for purchase. If you would like to learn a particular technique or if you are struggling with your technique then we suggest that you book a training session with Andrea.


 Cosmetic Tattoo Training by Andrea Darby

Training is the most important investment that a cosmetic tattoo technician can make for the future of their career, it often puzzles me why anyone would think that they can offer services to members of the public for hundreds of dollars without spending an adequate amount of money on their own training in the first instance, the more training and experience the better.

On a strictly limited basis I sometimes offer boutique one on one and small class training with an honest desire to provide accurate educational information based upon evidence based practice, and I have conducted rigorous research of the medical and scientific literature related to cosmetic tattooing on an ongoing basis and we have published authoritative articles on a wide range of topics and published them here for our clients and customers. Our articles have been plagiarised by others so often that we had to publish an another article explaining why it is unethical to plagiarise.

I have previously trained some of the leading technicians in Australia and internationally, training is based upon the core principles of ethics and best practice together with a genuine desire to assist students with their education with reliable well researched information, click here for further information on training.

Private Client Bookings:

 Cosmetic Tattoo Services by Andrea Darby

To make a booking for Cosmetic / Medical Tattoo client services contact Andrea by email.

Copyright: © 2019 All Rights Reserved. No copying, transmission or reproduction of any of the above content is permitted without our prior written consent.

Disclaimer: The content of this case study should be regarded as general information & is provided solely for the purpose of discussion & is not intended to replace cosmetic tattoo training or medical advice in any instance, always check with a qualified cosmetic tattoo educator and or a qualified medical practitioner before acting on any information regarding cosmetic tattooing or in relation to any medical condition or medical circumstance.

This information is not intended to be a 'how to guide' nor to replace recommended comprehensive Training by Andrea Darby it is merely an overview of the kinds of results that can be achieved and the types of equipment and products that were utilized.

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No Plagiarising