Reconstruction of the nipple-areola complex is one of the final processes of post-mastectomy surgical rehabilitation. Historically, various techniques of nipple restoration make use of local flaps. The areola reconstruction is then performed with skin grafting or else created through tattoo pigmentation of skin around the nipple reconstruction. Although variable long-term projection of the nipple is achieved, projection behind the areola has not been addressed. Thus many patients continue to lack the overall projection of the nipple and areola complex that creates a more natural appearance. A versatile alternative is offered in which the nipple component and the areola surface area can both be easily created using local tissues to provide for 1) lasting shape and 2) adequate projection of both the nipple and the areola. Since 1996, the CD flap with pursestring technique has been used to reconstruct 145 nipple-areola complexes in 118 patients. The nipple portion is based from the D flap and is supported by the base assembly of both the C and D flaps in a jigsaw fashion. Our approach has been successfully used for both implant-based and autologous tissue-based reconstructions to provide for lasting shape and adequate projection.