Background: This report describes the authors' currently favored method of nipple reconstruction in cases of a pre-existing scar on the breast mound that passes through the intended site of nipple reconstruction.
Methods: The star flap technique incorporating a previous scar is used at least 3 months after satisfactory implant-based breast reconstruction. If the intended site of nipple reconstruction bisects through a vertical mastectomy scar, the star flap is designed as medially or laterally based with its 2 lateral limbs lying adjacent to the scar and the transverse central component incorporating the vertical scar.