Nipple-areola complex (NAC) reconstruction is an essential component of each breast re-construction technique as it plays a major role in achieving optimal aesthetic results. Its goal is to obtain an appropriately located, sized, shaped, colored and textured NAC when compared to the controlateral one or to ideal landmarks. Several surgical techniques have been developed to obviate the neo-nipple’s loss of projection and contracture, mostly due to an inadequate NAC vascularization. Local flaps are the best choice when provided with a well-vascularized and sufficiently thick soft tissue, while grafts are better when there is a lack of local tissue and a donor zone is required to provide an adequate volume to the NAC. An autologous cartilage graft can also be used in similar situations to provide a long-lasting projected nipple. Tattooing is often used both to improve a newly created NAC and as an alternate two-dimensional reconstructive technique.