The reconstruction of the nipple and areola is possible with various procedures. One possibility is to create the nipple mound from skin taken as a local flap. Sometimes a small piece of cartilage from the ribs can be used to support the reconstructed nipple. In our Clinic for Plastic Surgery in Berlin, we usually reconstruct the nipple using the star flap technique that leads to the formation of symmetric positioned nipples without the need of a general anaesthesia. The reconstruction of the nipple should follow about 3 months after the initial reconstruction of the breast. This is the time needed for the tissue swelling to subside so that a symmetric positioning of the nipple can be possible. In a later time period, not earlier than 6 weeks, the areola can be reconstructed. This is usually performed though tattooing according always to the patients skin type and pigmentation. The reconstruction of the areola can also be performed ,when desired from the patient, by using a skin graft from both upper eyelids (Blepharoplasty-Eyelid lift) when skin excess is present, so that the uneven level of a natural areola can be simulated. The skin in this area is ideal for this procedure but the decision to proceed with it should always be together with the patient and individually decided.

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