The nipple and areola are well vascularized and richly innervated by terminal branches of the intercostal nerves. The nipple contains the ends of the milk ducts. There are considerable variations in areola size as well as the lateral projection of the mammilla. The size of the areola/nipple, as well as asymmetries of the mammilla-areola complex, may be easily corrected by simple surgical procedures under local anesthesia. Some women have inverted nipples, which may make breasfeeding difficult. Correction of inverted nipples is done under local anesthesia; possible relapses sometimes make a reoperation necessary.
An absence of one or both nipples is usually a consequence of breast cancer, trauma, or a congenital defect (athelia). Numerous methods of nipple and areola reconstruction have been described. Nipple reconstruction is usually done with the use of local flaps or in combination with an autotransplant of auricular cartilage. Reconstruction of the areola can be performed with a skin autotransplant or by tattooing. All the above procedures are done under local anesthesia, and the recovery period is 7 to 10 days.