3D Areola - Case 1

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Medical Tattooing

3D Areola



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3D SAT (Areola Tattooing) (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: Blond
Grey Light Blond Blond Strawberry Blond Red Light Brown Medium Brown Dark Brown Black

Before Photo

After Photo

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.

However for some highly specialised procedures such as was required for this client more advanced equipment such as the
Amiea Sense is required for the best possible outcome. The SensiDrive was utilised to minimise the risk of tissue trauma to the graft during tattooing as can occur with standard equipment and the Amiea Sense also has the advantage of being able to use some specialised needle profiles that are not currently available for some other devices.

Side by side Amiea Digital Machine Comparisons.

The Amiea Cool Spot is the ideal piece of equipment to cool skin to precisely the right temperature to minimise swelling and control pain and bleeding, because of the precise temperature control Cool Spot is superior to any other form of skin cooling such as cold packs or older style Cryo units. Cool Spot can be used as a stand alone unit or as an accessory plug in for the Amiea Sense machine.

NB. I have performed some procedures from start to finish without any other form of pain control other than the use of the Cool Spot.

Needle Profiles:

 TPA Cartridges for Amiea Sense


 Amiea Pigments

       Main Body of Areola

For the vast majority of Cosmetic Tattoo procedures I advise against mixing pigment colours together as there is a risk of creating a 'mud mix' this is a muddy brown/blue/grey colour that can result from mixing colours unnecessarily, however for some specialised procedures such as this particular case the blending of a range of colours is required for an optimal result.

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 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 NICNAS 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.

NB. the cost of our 3D-SAT Workbook can be applied as a discount towards our 2 day practical areola tattoo training program at a later date if requested.


 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. For medical tattoo training I generally suggest that the technician has at least 2 years full time cosmetic tattoo experience or they have a health service qualification.

Associated Training Courses, Materials & Supplies

Prospective students are sometimes overly influenced by flashy websites, prolific posting on social media, false claims about the invention of new techniques, promotion and awards by industry groups/associations in exchange for fees (media marketing), false claims about years of trainer experience, cross promotion by self interest groups, glamour photo shoots, pseudoscience, dodgy finance plans and high pressure sales tactics.

The reality is that anyone can buy a website, or pay fees to obtain awards and endorsements there are no shortage of people offering these kinds of marketing products, anyone can (or pay someone else to) spend all day posting photo shopped photos in the social media, anyone can make dubious claims about their years of experience or their level of knowledge there is nothing to prevent this. Sadly these kinds of practices do take place and they are of little genuine benefit to prospective students.

There are lots of associations out there and a lot of money is changing hands for annual fees, awards and marketing, yet we are still the only ones who provide Open Access Industry Health & Safety Alerts regarding critical information within the medical and scientific literature, our notifications are posted free of charge for the international industry and expert authors have even requested that we add their publications to our notifications stream.

I offer boutique one on one and small class training with an honest desire to provide accurate educational information based upon evidence based practice, I hold a Cert IV in Training and Assessment which actually qualifies me to create and deliver training services here in Australia. I am still the only Cosmetic Tattoo Trainer in Australia who has been independently assessed and Board Certified as an Instructor with the worlds most prestigious Cosmetic Tattoo association the American Academy of Micropigmentation. My partner (who is a Registered Health Practitioner) and I conduct 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 provided them to the international industry to read free of charge. Our articles have been plagiarised by others so often that we had to publish an another article explaining why it is unethical to plagiarise.

My training is based upon the core principles of ethics and best practice together with a genuine desire to assist students with their education, 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 or telephone: 0423 230 740

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

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No Plagiarising



28/04/2019, 01:53 PM

"First class result and an incredible amount of detail in the case study, I have not seen any other website that provides this level of in-depth information about the service and equipment that is used."

27/01/2019, 03:19 PM

"Awesome information thank you so much for sharing this"

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