Since I didn’t make it very clear the other day that the article posted was a continuation of My Nipples pt 1, I’m repeating the information from that article here.
Over the years Dr. Elliott has developed a technique that seems to work very well and have a high success rate. What he uses is a modified star flap reconstruction. Scroll down to file number seven in the linked document to get a basic idea. Dr. Elliott noticed that with the actual star flap reconstruction, the tips of the star tended to die. What he does instead is curve the ends so instead of points, the flaps look more like the ends of long ovals.
The longer a flap is, the more projection the nipple will have. The wider the flap is, the more circumference the nipple will have.
Dr. Elliott also uses a small pearl of fat from the breast mound to help prop up the flaps of surface tissue (aka skin).
Now, as for why there is nipple shrinkage: Any time an incision is made, scar tissue forms. Scar tissue contracts tightly to bond the incised tissues together. Thus, you get shrinkage when you have any sort of local flap nipple reconstruction.
I tried to replicate what Dr. Elliott showed me in the diagram to the left. You’ll probably have to zoom in to get a good look. I hope this diagram explains the differences in the flaps better than the text explanation.
As usual, if you have any questions, drop me a line in email or leave a comment here.