Oncological dermopigmentation enables the reconstruction of the nipple-areola complex following breast cancer treatment. In patients with left-sided breast cancer, the heart's anatomical proximity influences radiotherapy planning, potentially resulting in specific tissue characteristics that affect subsequent pigmentation. Alterations in vascularization, fibrosis, elasticity, skin thickness, hyperpigmentation, and scarring can modify pigment implantation and retention, necessitating adaptations to the conventional technique. This study analyzes the physiological response of left breast skin following radiotherapy and its impact on oncological dermopigmentation, considering parameters such as depth, pressure, speed, and the number of passes. The objective is to establish specific technical criteria for adapting the procedure to the characteristics of the irradiated tissue, thereby facilitating a safe, predictable, and clinically reproducible reconstruction of the nipple-areola complex.