Hypopigmentation, fibrosis, and the risk of autotransplantation of malignant cells have resulted in diminished enthusiasm for preserving the nipple-areolar complex after mastectomy. Adequate color match for areola reconstruction can be obtained with a full-thickness medial groin graft after breast mound symmetry has been achieved. Both a single-stage and a two-stage technique are described for nipple reconstruction. These techniques use existing approaches with some modification, and provide nipple-areolar complexes that are symmetrical, have satisfactory color match, and provide good nipple projection. Most important, the contralateral nipple-areolar complex is not violated. It can be dealt with as deemed best in terms of cancer prophylaxis.