Can Montgomery tubercles impact aesthetic 3D nipple-areolar complex tattooing? An anatomical, quantitative analysis of breast cancer patients

•Reconstruction of the NAC is integral to breast reconstruction, increasing multiple quality-of-life domains.•A variety of techniques may be employed to reconstruct the NAC, including local grafts, flaps, and 3D NAC tattooing.•Despite the importance of NAC reconstruction, scant studies have examined the influence of patient characteristics on NACs.•Our study suggests that NAC projections, termed Montgomery tubercles, are influenced by menopausal status.•3D NAC tattoo artists may consider menopausal status when deciding quantity of Montgomery tubercles for an aesthetic tattoo.