재발 함몰유두 교정방법

Recurrent Inverted Nipple; The useful technique for the difficult cases

Yoon, Sang Yub

Silhouette Clinic CBBC

Purpose of study:

Some methods have been developed, suggesting that no one technique is universally applicable to recurrent inverted nipple.

Recurrence may represent extreme frustration for the patient and the surgeon.

I propose the useful technique.

Subjects and Methodology:

During May 2007 and May 2015, these techniques were conducted on 173 patients with recurrent inversion.

I classified recurrent inverted nipples into three groups for surgical correction.

A trans-nipple incision extending from 3 o’clock to 9 o’clock was made.

I closely observed and removed the epithelial portion and some infected tissues.

And then I irrigated that portion with antibiotic solution vigorously.

Each 3-0 and 4-0 nylon sutures were placed through the nipple.

I accomplished surely corrected inversion of the nipple by suturing the internal platform and sidewalls of the nipple together (Fig. 1 - 3).

This technique has been performed in 21 recurrent patients (group I) with no infectious (n = 16) or infectious (n = 5) signs.

The CV flap for nipple reconstruction has been performed in 45 patients (group II) with the paucity of the nipple tissue.

The last patients (n = 107, group III) got conventional (simple purse-string) operation to correct the mild inversion or increase the height of the nipples.

Results:

The results were excellent in group III patients; nevertheless, 14 nipples were partially necrosis in group I & II.

Ten patients should get reoperation due to inversion or infection, but eventually the 8 cases recovered.

Unfortunately, in two cases these techniques failed.

Conclusion:

This technique provides reliable, useful long-term eversion for the severely inverted nipple.

Legend

Fig. 1.

Correction of a recurrent group I inverted nipple in a 22-year-old woman. Preoperative and postoperative photos.

Fig. 2.

The trans-incision is deepened vertically into the nipple extending from 3 o’clock to 9 o’clock.

Contracted fibrotic tissue separated from the lactiferous ducts with a scissors to loosen tissue by sharp dissection. In necessary cases, I removed the infected tissue and irrigate with antibiotics solutions.

Fig. 3.

3-0 nylon stitches is placed carefully to avoid injury at the base of the nipple (for formation of the platform) and 4-0 nylon stitch at the side of the nipple (for formation of the hard sidewalls)