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Areolar Tattoo Q&A with Evelyn Bacopulos. 

If you’ve undergone a breast reconstruction following mastectomy that included the removal of your nipples, you may be curious about nipple or areolar tattoo. Usually the last step in the reconstruction process, many women opt for 3D nipple tattoos—which create a surprisingly realistic and permanent representation of a nipple and/or areola—to help them feel more comfortable with the look of their reconstructed breast(s). 

At FORM Face + Body, it’s very important to us that we connect our patients to all the resources they will need and help guide them through their journey from start to finish. Today we’re speaking with Evelyn Bacopulos, an experienced tattoo artist who offers realistic areola repigmentation and 3D nipple tattoos at Bellwoods Tattoo in Toronto. She has kindly agreed to take some time to answer some common questions and provide us with more information about the areolar tattoo process.

What is areolar tattoo, and what techniques do you use? Does it differ from regular tattoos?

 Areolar tattoos or 3D nipple/areola repigmentation is a final stage of the breast reconstruction process, in which tattooing is used to create a hyper realistic and permanent representation of a nipple and/or areola on someone’s skin for those who need or desire it. Traditional tattoo machines, pigments and techniques are used to ensure a permanent, realistic and lasting effect.

How long have you been doing this, and what first inspired you to start?

 I’ve been tattooing traditionally since 2007 and began doing areolar and 3D nipple tattoos a little over 2 years ago now. I guess what prompted my interest initially was my mother’s breast cancer diagnosis, and in time realizing how much of a need there actually was for such a service. I wanted to be a part of some form of a solution and make the service a bit more financially available to women. I wanted to use my skill set to help in some way. 

What does the process of working with you look like, from start to finish?

 We begin with a virtual consultation where we discuss the client’s medical history and specific needs. From there, I will create a colour palette and digital mock-up based on the client’s photos and skin tones for them to review prior to their appointment. I strive to make the process very collaborative and completely custom. On the day of their appointment, the tattooing itself can last around 1-2 hours. Clients are sent home with very specific aftercare instructions and a product packet to use during the healing time. This tattoo is made to last, so only one session is typically required. That being said, there is a mandatory follow up 6-8 weeks later to ensure quality and optimal healing. At this short appointment we will do any necessary touch-ups, but quite often none are needed. 

How do you choose the shape and colour of the nipple and areolar tattoo?

 That is completely up to the client. The process is very collaborative, but I base the colour palette on their skin typically, and sometimes a client will provide a photo of their nipple prior to mastectomy and we can create from that reference. Other times clients will opt for a larger or smaller areola than they had previously, even shapes like hearts are requested. 

Are the tattoos permanent?

 Yes, definitely. 

Does it hurt?

 It can, but there are a variety of topical numbing agents to help manage this. I use one that I like and have it at the shop if needed. Oftentimes however, patients still have numb areas after surgery and thus don’t experience any pain at all.

What does the healing process look like?

 After the tattoo is completed, I clean and bandage the area. Clients are to keep the bandage on overnight with a loose bra on and try their very best to sleep on their back. Clients are asked to wash twice daily. Some flaking or scabbing may occur; this is normal. The main idea is to keep the area clean and dry for the first couple of days, then hydrated until healed, but not to use excess amounts of lotion. You should heal completely in a week or so but it may take several weeks for the area to settle into its final appearance. 

Can you tattoo radiated skin?

Yes, with care. 

How long should I wait after my surgery before getting areolar tattoos?

 I recommend 4-6 months at the very least, but at the guidance of your surgeon or oncologist. 

How meaningful is it for you to be able to provide this service to breast cancer survivors?

 It has been the most rewarding experience of my career, by far. Absolutely nothing prepared me for how fulfilling it could actually be. Hearing all of the stories, experiences. Having their trust and loving gratitude, these women have been amongst the strongest and most graceful. I have learned so much and I am truly forever changed. There is nothing I cherish more in my career than the work that I do for them. 

If you’re interested in learning more about areolar tattoo, or scheduling a consultation with Evelyn, you can reach her via email at You can also find more information on her website, or view results on Instagram (@tattoosbyevelyn). 

If you have any questions about breast reconstruction, or to book a consultation, don’t hesitate to get in touch with our team at or (416) 447-6176.