After a mastectomy, it is incredibly personal and individual. Some women are comfortable "going flat" and some feel that reconstructed breast mounds are enough, while other women seeking full reconstruction feel the process isn't complete without nipples. For them, nipples are a defining focal point of the breast.
Adding a nipple to a reconstructed breast can have an immediate and profound visual effect, helping the breast look more normal again. New nipples can also draw attention away from the scars, lopsidedness, indentations and other imperfections of surgery. In my own practice, I've seen what an important therapeutic step it has been for many of my patients.
In some cases, a woman's natural nipple can be preserved during mastectomy surgery. But when that's not possible, there are two different ways to permanently create a new nipple. One option is to use the woman's own tissue to create a round nipple and areola "bump out" or projection. That little cap can be tattooed for color later on. Another option is to tattoo a nipple directly on the breast mound. Nipple tattoos without reconstructed nipples are increasingly popular, especially 3D nipple tattoos that look amazingly real.