Various techniques of reconstruction of the nipple-areola complex are reviewed. An analysis of the criteria for an aesthetically pleasing nipple-areola complex is made. Symmetry appears to be the single most important factor in achieving the objective. More than color, texture, or the amount of projection, symmetry appears to provide the best overall result. Those techniques that treat areolae in identical fashion are more likely to produce symmetry. Reducing the normal nipple size not only provides donor tissue but reduces the problem of projection, which otherwise interferes with achievement of symmetry.
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