Creating the nipple areola complex (NAC) is often a final step in breast reconstruction. Though not necessary, research has shown that women with NAC reconstruction are more satisfied with their breast reconstruction. This is likely because the nipple turns a mound into an actual breast form.

There are different way of creating a nipple and areola, and most plastic surgeons will choose a specific methods based on the type of breast reconstruction (implant vs. autologous “flap” tissue) you have previously undergone.

Popular nipple flaps include the Skate flap and the C-V flap (image below). Regardless of which approach your surgeon chooses, the outcome will be a nipple mound. The areola can then be either tattooed, or it can be reconstructed with a skin graft taken from elsewhere on your body. It is common for the newly-created nipple to lose projection over time , and for that reason many surgeons may initially over project the nipple during reconstruction.

Nipple Areola complex reconstruction, NAC reconstruction, skate flap, CV, flap, C-V flap, Nipple reconstruction, Nipple Tattoo

NAC reconstruction is usually an hour, and is often done in a same day surgery setting. Once you have healed, you will have the tattooing done in your surgeon's office or in a same day surgery center. Healing time is usually a few weeks with very few restrictions.

Not all patients are candidates for nipple reconstruction. Talk to your surgeon if:

  • you are an active smoker

  • you are an uncontrolled diabetic

  • you have had radiation to your breast

All surgeries have risks. Talk to your doctor about the risks associated with each procedure. 

Lastly, some patients want nipple reconstruction but do not want to undergo another procedure. These patients may choose the non-surgical option of a 3-D nipple tattoo. This allows color pigmentation to simulate the nipple areola without the contour of an actual nipple. Talk to your surgeon about this option.