Restoring the nipple–areola complex completes the breast reconstructive.

Local flaps are often used for the nipple reconstruction; however, the number of techniques indicates the lack of a superior design.

The aims of this study were to test the feasibility of a new triple flap design for nipple reconstruction and to evaluate complication rate and nipple projection.

From November 2015 to November 2018, we performed the triple flap nipple reconstruction guided by a template for preoperative mark-up.

Patients were followed up postoperatively to evaluate healing and signs of complications including wound dehiscence, infection, and flap necrosis, and nipple projection.

We present the new triple flap design for nipple reconstruction guided by a template for mark-up. The preliminary results indicate a low complication rate in both irradiated and nonirradiated patients while sustaining the projection over time remains to be a challenge.