As the breast is a symbol of feminity, so nipple areolar complex is a crucial aesthetic unit of the breast. Symmetrical and appropriate nipple areolar complex completes the breast reconstruction.
  Throughout the history of breast reconstruction, various methods of nipple areolar reconstruction have been developed. Composite graft and several local flap methods have been used for reconstruction of nipples. Skin grafts from contralateral areolar or inguinal area and tattooing methods have been introduced for areolar reconstruction.
  Among 85 patients of breast reconstruction during recent three years, we experienced only 14 cases of nipple areolar reconstruction. This fact is partly from conservative attitude of Korean women to breast reconstruction and also from the long time-period needed to accomplish an acceptable breast mound.
  For nipple reconstruction, we performed eight H-shape local flaps, three fish tail shape local flaps, and three composite grafts. For reconstruction of areola, full thickness skin graft was used in 13 cases(10 from inguinal area, 3 from contralateral areola) and tattooing was used in a case. We experienced necrosis of reconstructed nipple in two cases(one in fish tail shape local flap cases and one in composite graft cases). There was no other remarkable complication. Among the three methods of nipple reconstruction, H-shape local flap method was a reliable one which provieds stable nipple projection as well as simplicity. In most cases areola was successefully reconstructed with full thickness skin graft and if the size of contralateral areola is large enough to share, contralateral areolar sharing seems to be the best choice.
  In conclusion, the combination of a H-shape local flap and a full thickness skin graft from the inguinal area provides a satisfactory projection of the nipple and pigmentation of the areola comparable to the other side.