After you are happy with the shape and size of your reconstruction and time has passed for you to heal, you may consider having a nipple reconstructed. The nipple created by your surgeon will not be like your natural nipple. It will not react to temperature or touch by flattening and becoming larger, and will not have "feeling." Depending on the type of breast reconstruction, reconstructed nipples may appear more or less “perky” than others. Because of this, many women are content to go without a nipple on their reconstructed breast.
If you choose to have nipple reconstruction, there are a variety of techniques. Most procedures involve using the skin of your breast reconstruction, such as the procedures shown below. Another option is to take a portion of natural nipple from your other breast (if it is large enough) and graft it to the reconstructed breast. These techniques often do not require a visit to the operating room, and can be performed in an office setting.
The areola (the colored portion around the nipple) is most often recreated with a tattoo. The illusion of a nipple can also be created by having a tattoo made with a central region that is darker than the rest. There are a variety of available flesh tone colors to create a natural-appearing areola. Areolar tattooing is usually painless and can be performed in an office setting. Most tattoos will fade as much as 40% over time and may need to be reapplied after a few years.
Another option is to use a graft of skin from another location of the body, usually your inner thigh or waist. Skin from these areas of the body has a natural tendency to heal darker when it is grafted. Areola grafts are performed in the operating room.