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Published in: Aesthetic Plastic Surgery 1/2022

01-02-2022 | Inverted Nipple Correction | Original Article

A New Technique in Correction of Nipple Inversion Using Dermal C Flaps

Authors: Bilge Kagan Aysal, Celalettin Sever

Published in: Aesthetic Plastic Surgery | Issue 1/2022

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Abstract

Background

Nipple inversion, which is defined as a nipple located on a plane deeper than the areola, presents both functional and cosmetic problems. Surgical repair of severe cases involves suture or flap techniques. In the present study, an alternative repair technique using two cross dermal areolar flaps to correct challenging inverted nipples is presented. Releasing the inverted nipple is performed by severing the underlying tight fibrous tissue bands and canaliculi.

Methods

This is a retrospective case series. Fifteen patients who had been operated between January 2010 and January 2016 were included in the study. Seven of these had bilateral inverted nipples. Patient age at operation ranged from 26 to 47 years (mean age, 32.5 years). All nipples were congenital, with no previous operations. The follow-up period ranged between 8 and 16 months (mean of 13 months).

Results

There were no complications associated with surgery, including infection, hematoma, permanent sensory disturbance, or nipple necrosis. Unilateral recurrence occurred in one patient on the 26th postoperative day. This patient was reoperated on successfully using the same method. Adequate projection was achieved in all patients. All patients were satisfied with their results.

Conclusions

The authors conclude that their procedure is a reliable, simple, safe, and effective method for correction of inverted nipples. The alignment of the scar with the junction of the nipple and the areola leads to a more aesthetic appearance with no apparent scarring. This technique can be applied to any type of inverted nipple as a primary surgical procedure.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literature
1.
go back to reference Moseley HF, Miller GG. Textbook of Surgery. St. Louis: C. V. Mosby; 1952. p. 269-72. Moseley HF, Miller GG. Textbook of Surgery. St. Louis: C. V. Mosby; 1952. p. 269-72.
2.
go back to reference Regnault P (1975) Nipple Hypertrophy, A physiologic reduction by circumcision. Clin Plast Surg 2(3):391–396CrossRef Regnault P (1975) Nipple Hypertrophy, A physiologic reduction by circumcision. Clin Plast Surg 2(3):391–396CrossRef
3.
go back to reference Lee KY, Cho BC (2004) Surgical correction of inverted nipples using the modified Namba or Teimourian technique. Plas Reconstructive Surg. 113(1):328–36CrossRef Lee KY, Cho BC (2004) Surgical correction of inverted nipples using the modified Namba or Teimourian technique. Plas Reconstructive Surg. 113(1):328–36CrossRef
4.
go back to reference Kim DY, Jeong EC, Eo SR, Kim KS, Lee SY, Cho BH (2003) Correction of inverted nipple: an alternative method using two triangular areolar dermal flaps. Ann Plast Surg 51(6):636–640CrossRef Kim DY, Jeong EC, Eo SR, Kim KS, Lee SY, Cho BH (2003) Correction of inverted nipple: an alternative method using two triangular areolar dermal flaps. Ann Plast Surg 51(6):636–640CrossRef
5.
go back to reference Durgun M, Ozakpinar HR, Selcuk CT, Sarici M, Ceran C, Seven E (2014) Inverted nipple correction with dermal flaps and traction. Aesthetic Plast Surg 38(3):533–539CrossRef Durgun M, Ozakpinar HR, Selcuk CT, Sarici M, Ceran C, Seven E (2014) Inverted nipple correction with dermal flaps and traction. Aesthetic Plast Surg 38(3):533–539CrossRef
6.
go back to reference Jeong HS, Lee HK (2015) Correction of inverted nipple using subcutaneous turn-over flaps to create a tent suspension-like effect. PloS one 10(7):e0133588CrossRef Jeong HS, Lee HK (2015) Correction of inverted nipple using subcutaneous turn-over flaps to create a tent suspension-like effect. PloS one 10(7):e0133588CrossRef
7.
go back to reference Kolker AR, Torina PJ (2009) Minimally invasive correction of inverted nipples: a safe and simple technique for reliable, sustainable projection. Ann Plast Surg 62(5):549–553CrossRef Kolker AR, Torina PJ (2009) Minimally invasive correction of inverted nipples: a safe and simple technique for reliable, sustainable projection. Ann Plast Surg 62(5):549–553CrossRef
8.
go back to reference Han S, Hong YG (1999) The inverted nipple: its grading and surgical correction. Plast reconstructive Surg 104(2):389–95CrossRef Han S, Hong YG (1999) The inverted nipple: its grading and surgical correction. Plast reconstructive Surg 104(2):389–95CrossRef
9.
go back to reference Hwang K, Kim DH (2013) Half Z-plasty, band release, and cavity filling for correction of inverted nipple. J Plast Surg Hand Surg 47(2):93–96CrossRef Hwang K, Kim DH (2013) Half Z-plasty, band release, and cavity filling for correction of inverted nipple. J Plast Surg Hand Surg 47(2):93–96CrossRef
10.
go back to reference Teng L, Wu GP, Sun XM, Lu JJ, Ding B, Ren M et al (2005) Correction of inverted nipple: an alternative method using continuous elastic outside distraction. Ann Plast Surg 54(2):120–123CrossRef Teng L, Wu GP, Sun XM, Lu JJ, Ding B, Ren M et al (2005) Correction of inverted nipple: an alternative method using continuous elastic outside distraction. Ann Plast Surg 54(2):120–123CrossRef
11.
go back to reference Min KH, Park SS, Heo CY, Min KW (2010) Scar-free technique for inverted-nipple correction. Aesthetic Plast Surg 34(1):116–119CrossRef Min KH, Park SS, Heo CY, Min KW (2010) Scar-free technique for inverted-nipple correction. Aesthetic Plast Surg 34(1):116–119CrossRef
12.
go back to reference Zhou H, Tan Q, Wu J, Zheng DF, Zhou HR, Xu P et al (2011) Correction of inverted nipple with bilateral areolar rhomboid dermal flaps. J Plast Reconstructive Aesthet Surg JPRAS. 64(6):e159–e161CrossRef Zhou H, Tan Q, Wu J, Zheng DF, Zhou HR, Xu P et al (2011) Correction of inverted nipple with bilateral areolar rhomboid dermal flaps. J Plast Reconstructive Aesthet Surg JPRAS. 64(6):e159–e161CrossRef
13.
go back to reference Yamada N, Kakibuchi M, Kitayoshi H, Kurokawa M, Hosokawa K, Hashimoto K (2004) A method for correcting an inverted nipple with an artificial dermis. Aesthet Plast Surg 28(4):233–238CrossRef Yamada N, Kakibuchi M, Kitayoshi H, Kurokawa M, Hosokawa K, Hashimoto K (2004) A method for correcting an inverted nipple with an artificial dermis. Aesthet Plast Surg 28(4):233–238CrossRef
14.
go back to reference McGeorge DD (1994) The “Niplette”: an instrument for the non-surgical correction of inverted nipples. Br J Plast Surg 47(1):46–49CrossRef McGeorge DD (1994) The “Niplette”: an instrument for the non-surgical correction of inverted nipples. Br J Plast Surg 47(1):46–49CrossRef
15.
go back to reference Pereira OJ, Bins-Ely J, Granemann AS, Lee KH (2009) Correction of inverted nipples by strong suspension with areola-based dermal flaps. Plast Reconstructive Surg 123(3):1132CrossRef Pereira OJ, Bins-Ely J, Granemann AS, Lee KH (2009) Correction of inverted nipples by strong suspension with areola-based dermal flaps. Plast Reconstructive Surg 123(3):1132CrossRef
16.
go back to reference Schwager RG, Smith JW, Gray GF, Goulian D Jr (1974) Inversion of the human female nipple, with a simple method of treatment. Plast Reconstr Surg 54(5):564–569CrossRef Schwager RG, Smith JW, Gray GF, Goulian D Jr (1974) Inversion of the human female nipple, with a simple method of treatment. Plast Reconstr Surg 54(5):564–569CrossRef
17.
go back to reference Skoog T (1952) An operation for inverted nipples. Br J Plast Surg 5(1):65–69CrossRef Skoog T (1952) An operation for inverted nipples. Br J Plast Surg 5(1):65–69CrossRef
18.
go back to reference Spina V (1957) Inverted nipple; contribution to the surgical treatment. Plast Reconstr Surg 19(1):63–6CrossRef Spina V (1957) Inverted nipple; contribution to the surgical treatment. Plast Reconstr Surg 19(1):63–6CrossRef
19.
go back to reference Dessena L, Dast S, Perez S, Mercut R, Herlin C, Sinna R (2018) Inverted nipple treatment and poliglecaprone spacer. Aesthet Plast Surg 42(4):958–963CrossRef Dessena L, Dast S, Perez S, Mercut R, Herlin C, Sinna R (2018) Inverted nipple treatment and poliglecaprone spacer. Aesthet Plast Surg 42(4):958–963CrossRef
20.
go back to reference Mathur B, Loh CYY (2019) Sensation-sparing correction of inverted nipples using the “drawbridge” flap approach. Aesthet Plast Surg 43(2):348–353CrossRef Mathur B, Loh CYY (2019) Sensation-sparing correction of inverted nipples using the “drawbridge” flap approach. Aesthet Plast Surg 43(2):348–353CrossRef
21.
go back to reference Sowa Y, Itsukage S, Morita D, Numajiri T (2017) Inverted nipple correction with selective dissection of lactiferous ducts using an operative microscope and a traction technique. Aesthet Plast Surg 41(5):1045–1048CrossRef Sowa Y, Itsukage S, Morita D, Numajiri T (2017) Inverted nipple correction with selective dissection of lactiferous ducts using an operative microscope and a traction technique. Aesthet Plast Surg 41(5):1045–1048CrossRef
Metadata
Title
A New Technique in Correction of Nipple Inversion Using Dermal C Flaps
Authors
Bilge Kagan Aysal
Celalettin Sever
Publication date
01-02-2022
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 1/2022
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-021-02521-y

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