Areola-nipple complex micropigmentation in breast reconstruction: Patient perspective and psychosocial benefits

Introduction Areola–nipple complex (ANC) reconstruction represents the final and essential step in breast reconstruction after mastectomy for breast cancer, which affects approximately 37,000 women annually in Spain. ANC micropigmentation is a safe and effective technique that restores the natural appearance of the breast, enhancing psycho-emotional well-being, body image, and self-esteem. The Breast Unit of Hospital Universitario Miguel Servet (HUMS) implemented this service in 2023. Material and methods A descriptive, retrospective pilot study was conducted at HUMS (May 2023–February 2025). Patient satisfaction was evaluated in 12 of 18 women who underwent ANC micropigmentation using a self-administered questionnaire. Specialised professionals performed the procedures aiming to reproduce the colour, shape, and three-dimensional (3D) appearance of the ANC. Results Micropigmentations were performed on the right breast (41.7%), bilaterally (33.3%), and the left breast (25.0%). All patients (100%) initially perceived colour and size positively, although all experienced pigment fading requiring repigmentation. Most participants (91.7%) reported that their personal preferences were considered. Satisfaction with the aesthetic result (colour, naturalness, overall appearance, shape, and size) was consistently high, as was satisfaction with the care process and staff. All patients (100%) stated they would recommend the procedure and undergo it again. Conclusions Areola–nipple complex micropigmentation is a fundamental component of post-mastectomy breast reconstruction, significantly improving body image and psychosocial well-being. This pilot study validates its effectiveness, demonstrating high satisfaction with both aesthetic outcomes and the care process. The unanimous willingness to recommend the procedure underscores its clinical relevance and supports its integration into standard reconstructive care pathways.