My reconstruction surgeon did nipple reconstruction from the skin on the breast, even though it was very thin. About 3 years later, it is almost completely flat. I just saw my cancer surgeon this week, and he said that often, the reconstruction eventually flattens out - as mine has. I also did tattoos for the areola, and those faded almost immediately. I had a second round which also didn't really take. I am now - mostly - at peace with the hardly visible nipple and areolas. The reconstruction looks great in clothes, not too bad naked. Just glad that I don't have to deal with prostheses, and that dressed, I look quite normal.
FYI: It takes time for the implants to feel normal - I would say that it gets more comfortable and natural over time - but it seems more that I am accustomed to the difference - not that it feels like natural breasts. There is extremely diminished sensation, and it feels mush of the time as if I am wearing (somehow, on the inside!) a bra that is just a bit too snug.)
Good luck to you - getting the reconstruction done means you are nearing the end of the treatment!

They can sometimes use your own skin from mastectomy but , as in my case, the skin is too thin. The alternative is grafting from the labia (genitals)... Ouch! No thank you! I've opted not to have a nipple. It would have no feeling anyway. There are 3-D tattoo artists who do a pretty realistic job and this way you wouldn't be poking out all the time ;)

At the time, getting nipple reconstruction was extremely important to me. 3 years later (see answer above) the reconstruction and tattoos are almost invisible, but I am pretty much at peace about it. If I had it to do again, and could see into the future regarding both how they would look and how I would eventually feel, I'm not sure I would have bothered. I know I would not have been and am not willing to cut up another part of my body and undergo more and intense pain on still another body part to build "nipples" that might look ok, but have no sensation.
Good luck to you, though, and choose what feels right - whatever you decide is the right choice for you.

Thanks for the information, Gabrielle. Anything's got to be better than this tissue expander!

I just had mine done it will be two weeks Wednesday. It didn't hurt at all. They only numbed the breasts and used my breast tissue to create them. I have to wait three months before the tattooing according to my insurance. If they go flat I will not have them replaced, but I would be open to the 3 D tattooing.