ABSTRACT
Reconstruction of the nipple areolar complex is usually the final stage of breast reconstruction and provides an extremely valuable adjunct to the aesthetic appearance of the final result. The most widely used form of reconstruction is a local flap, utilising skin and subcutaneous flap. At a minimum of 3 months post-operation, patients are seen in a specialist nurse-led clinic to discuss tattooing of the reconstruction to recreate the areola skin paddle. Tattooing techniques have been refined to recreate the appearance of the glands of Montgomery on the areola and can be matched to the contralateral breast. Tattooing has largely replaced the use of skin grafts for areolar reconstruction in modern practice. A variety of grafts and implants have been used to attempt improved projection, including autologous tissue, allografts, acellular dermal matrices, and synthetic materials (fillers and silicone rods). Finally, it is important not to overlook the role of stick-on nipple prostheses.
