I assume you mean a transplant from a cadaver donor, as I think it would be hard to find a living patient who would be willing to give up one of her own nipples!Yet, this is a reasonable question since we have kidney, liver, heart, and many other organs that are donated and transplanted every day, so why not nipples?The answer is that use of someone else's tissues always causes rejection by the recipient (unless the donor is an identical twin), and why careful matching to reduce the rejection response severity is required--along with powerful anti-rejection drugs that themselves have side effects.So, for a kidney, heart, and now even hands and faces, matching and powerful drugs are acceptable trade-offs. But not for a nipple.Besides, if a person's nipple-areola graft fails, that patient has ample other options for nipple reconstruction, just as we do for our breast cancer patients. These options are pretty good, but not quite as good as "original equipment!"So if you're a candidate for nipple areola grafting with your top surgery, avoid any nicotine use or exposure to second hand smoke, and follow your surgeon's rules. Your risk of graft loss is in the low single digits. If you smoke (even one cigarette), use nicotine any other way (vape or e-cig), or are exposed to second-hand smoke, why risk the increased chance of graft loss (could be as high as 15-20%)?Thanks for the great question. I hope my answer clears that up adequately! Cheers! Dr. Tholen