Nipple reconstruction is a crucial aspect of breast reconstruction, focusing on restoring the aesthetic appearance of the nipple-areola complex (NAC). Techniques such as the C-V flap are commonly used, but they often face challenges in maintaining nipple projection over time, requiring overcorrection. The modified C-V flap, incorporating purse-string sutures, improves projection retention and reduces the need for revisions. A 63-year-old woman with a history of failed reconstructions underwent a modified C-V flap, achieving favorable results. This technique, combined with composite grafts and tattooing, addresses complications such as radiotherapy effects and enhances the overall outcome. The approach offers a reliable and personalized solution, optimizing long-term results in nipple reconstruction.