The role of nipple-areola complex tattooing in breast cancer psycho-physical rehabilitation: An updated review

Cosmetic interventions like Nipple-Areola Complex tattooing have been shown to improve outcomes in breast cancer survivors. Although it is a safe and well-tolerated technique that provides satisfactory aesthetic results, several research needs were acknowledged. This paper aims to briefly review the latest evidence regarding Nipple-Areola Complex tattooing for breast reconstruction proposes after oncological surgery, assessing studies' designs and the addressed outcomes, including any Patient Reported Outcome. Complete and primary published literature between 2023 and February 2025 was included. Pubmed, Embase, Cinahl, and Scopus were searched with these main keywords: Nipple, Areola*, Tattoo*, and dermopigmentation. A narrative synthesis was conducted to summarize the results. In the last two years, the amount of literature on the topic has increased, along with the technique application and its research interest. Observational designs [cross-sectional (N = 5); retrospective (N = 5); implementation project (N = 1); qualitative (N = 1)] addressed current research gaps, like quality-of-life assessment with validated instruments and organizational aspects. In line with previous literature, the Nipple-Areola Complex reconstruction's relevance, satisfaction with the cosmetic outcome, the fading phenomenon, and the factors influencing color durability were other outcomes assessed. Emotional, psychological, and sexual domains are patient-reported outcomes that benefit from Nipple-Areola Complex tattooing. Sustainability and professional training remain critical issues worthy of further comprehensive studies.