Procedures to replicate the nipple-areola complex have become significantly easier over time, thank goodness. Nipple-areola reconstruction procedures involve creating a raised nub of skin in the center of the breast mound with an area of darkened skin on and around it. Gone are the days when nipple reconstruction involved taking tissue from the vulva (ouch!) so that the skin would look darker and using a piece of cartilage from the ear (ugh!) to create the nub.
No wonder so many women decided not to fully complete their breast reconstruction! Many feel exasperated with the long process of reconstruction (and treatment) and just want the procedures to be over! However, the latest approaches make these procedures easier and much less invasive.
Skin-flap procedures have simplified the process. They are usually done as an office procedure, and they only require local anesthetics. Numbing medication is injected into the skin on top of the breast mound. The surgeon will free up a flap of skin (leaving a portion of it still attached) and swirl it into a nub, which is then sutured into a protrusion on the mound. The skin incision is then closed with stitches.
The surgeon will make this protrusion about twice the size as the desired end-result because the nub will shrink as it heals into place.
The eventual flattening of these constructed nipple nubs is another reason why some women are going directly to 3-dimensional nipple tattooing.
An excellent medical source that describes these nipple reconstruction skin flap procedures can be found at: E Medicine from Web MD.