Nipple-Areola Complex (NAC)

The Nipple-Areola Complex (NAC) comprises the central nipple and the surrounding pigmented areola; it contains milk ducts, smooth muscle fibers, sebaceous glands and a dense network of blood vessels and nerves that contribute to breast sensation and lactation. Size, shape, color and projection of the NAC vary widely among individuals and can change with age, hormonal shifts, pregnancy, breastfeeding, weight fluctuation or previous surgery.

In plastic and reconstructive breast care the appearance, position and sensation of the Nipple-Areola Complex (NAC) are important considerations when planning procedures such as reduction, augmentation, reconstruction or mastectomy. Surgeons use techniques to preserve vascular supply and nerve connections when possible, and options related to the NAC include nipple-sparing approaches, areola resizing or tattooing, nipple reconstruction or grafting, and corrective procedures for inversion or malposition; potential outcomes to discuss include changes in sensation, scarring, pigment alteration and, rarely, partial or full tissue loss.