The Sant Joan University Hospital of Reus has incorporated areola and nipple micropigmentation to complete breast reconstruction in patients operated on for breast cancer. The first patient to undergo this intervention at the center has been Beatriz Lozano, a resident of Reus, who received a breast cancer diagnosis at the end of 2022 and underwent surgery in 2023 with breast removal and oncological treatment at the same hospital.
The new service is integrated into the final phase of the reconstructive process, which can extend up to two years and which includes different interventions and recovery periods. The professionals of the functional unit of breast pathology place this technique within reparative surgery and not in the aesthetic field.
"It is the process that culminates the reconstruction. We always say it's like putting the cherry on top of the cake" - Cristina Marsal and Tere Godall, nurses of the functional unit of mammary pathology
A ambulatory technique for completing the reconstruction
Micropigmentation consists of applying pigments to the skin with a dermograph. It is done with a shallower depth than that of a tattoo and with a different methodology. The procedure is outpatient and usually requires two sessions, a first one to create the color base and a second one to refine the result and reinforce the three-dimensional effect.
The intervention is performed when the reconstruction has already consolidated and the oncological treatment has finished. Generally, it can be carried out between six months and one year after the main surgery, provided that at least six weeks have passed and the tissues are completely healed.
"It's almost like a work of art" - Cristina Marsal and Tere Godall, nurses of the functional unit of breast pathology
To achieve a natural result, the hospital takes the nipple of the other breast as a reference. The work adjusts to the shadows, colors, and application method to generate a sensation of volume, even in those cases where the patient does not opt for surgical nipple reconstruction.
"We try to make it symmetrical. For the color we mix the pigments manually, drop by drop, until we find the tone that most resembles it" - Cristina Marsal and Tere Godall, nurses of the functional unit of breast pathology
The nurses emphasize that not all patients choose to reconstruct the nipple with a new surgery. In those cases, micropigmentation allows for the creation of a visual relief effect.
"With the 3D technique you can generate the sensation that there is a nipple even if it is not physically there" - Cristina Marsal and Tere Godall, nurses of the functional unit of breast pathology
Forecast of between 20 and 25 procedures per year
Sant Joan Hospital has already performed three procedures of this type and plans to do between 20 and 25 each year. The incorporation of this technique expands care for patients who have undergone a mastectomy or breast reconstruction within the care circuit of the Reus center.
The professionals who apply it insist on the impact that this phase has on the body perception of the patients and on the closure of the process after the illness and the interventions.
"The most important thing is that when they look in the mirror, they recognize themselves a little more with their body. It is a process that helps the patient to feel like herself again" - Cristina Marsal and Tere Godall, nurses of the functional unit of breast pathology
The experience of the first patient
Beatriz Lozano received the diagnosis at the end of 2022. In 2023 she underwent breast removal and oncological treatment at the Hospital Universitari Sant Joan de Reus. During that process, breast reconstruction was done in the same operation as the mastectomy.
"When you receive a cancer diagnosis your world falls apart, but throughout the entire treatment I felt very accompanied" - Beatriz Lozano
"When I woke up I already had the volume of the chest" - Beatriz Lozano
The patient explains that during the hardest phase of the treatment her priority was to overcome the disease. Afterwards came the moment to decide if she would complete the reconstruction with micropigmentation.
"The most important thing was to cure myself of the illness" - Beatriz Lozano
Lozano admits that at first she was not convinced, although her assessment changed after the result. She assures that the intervention has allowed her to close a stage and recover the image she had of herself before the operation.
"I was not very keen on doing it at the beginning, but now I would recommend everyone who can do it to do it" - Beatriz Lozano
"When you look at yourself in the mirror you see yourself again as before. It's like putting the final point to the whole process" - Beatriz Lozano
"After the mastectomy I avoided looking at myself in the mirror, I didn't want to see myself. Now I feel like I'm myself again, I recognize myself as always and I feel that I have put an end to the whole process", summarizes the patient, who has become the first reference for this technique at the Reus hospital.