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Correction of Inverted Nipple Using Subcutaneous Turn-Over Flaps to Create a Tent Suspension-Like Effect.

Jeong HS, Lee HK - PLoS ONE (2015)

Bottom Line: Many techniques have been reported for the correction of inverted nipples.A single-institutional retrospective review was performed for all patients who received the modified operation.Surgical details are described within the main text.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic & Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Republic of Korea.

ABSTRACT

Background: Many techniques have been reported for the correction of inverted nipples. However, the conventional methods may be insufficient, especially for moderate to severe inversions. We propose a modification of Elsahy's method and report satisfactory results.

Methods: A single-institutional retrospective review was performed for all patients who received the modified operation. Patient charts were reviewed for demographic data, pertinent preoperative factors such as Han and Hong classification, and clinical outcomes including postoperative nipple height and sensation. Surgical details are described within the main text.

Results: The review identified 26 female patients amongst whom 47 inverted nipples were corrected using the modified method. The mean nipple height was 9 mm with an average follow-up period of 14 months. Brush stimulation elicited nipple contraction in all patients. There was no recurrence of nipple inversion, nor were there any surgical complications to report.

Conclusion: The suspension technique is a simple, reliable method for correcting grade II and III nipple inversions.

No MeSH data available.


Related in: MedlinePlus

A schematic diagram of the design of the method for inverted nipple correction.Full-thickness subcutaneous triangular flaps are designed as shown in the diagram after pulling out the inverted nipple. The red dotted circle means the base of the nipple before traction. B’ is the dermal point of approximation of D and D’ from the areola, and A’ is the dermal point of approximation of C and C’ from the areola. After traction of the inverted nipple, the circular area of the nipple base becomes larger. The long axis of the triangular flap is equal to the diameter of the nipple base (BB’ = B’A’ = A’A). The tip of the triangular flap, or A, is overturned and fixated to B’, which is the dermal point to which D and D’ of the areola are approximated. The tip of the opposite triangular flap, B, is then fixated to A’, to which C and C’ are approximated.
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pone.0133588.g001: A schematic diagram of the design of the method for inverted nipple correction.Full-thickness subcutaneous triangular flaps are designed as shown in the diagram after pulling out the inverted nipple. The red dotted circle means the base of the nipple before traction. B’ is the dermal point of approximation of D and D’ from the areola, and A’ is the dermal point of approximation of C and C’ from the areola. After traction of the inverted nipple, the circular area of the nipple base becomes larger. The long axis of the triangular flap is equal to the diameter of the nipple base (BB’ = B’A’ = A’A). The tip of the triangular flap, or A, is overturned and fixated to B’, which is the dermal point to which D and D’ of the areola are approximated. The tip of the opposite triangular flap, B, is then fixated to A’, to which C and C’ are approximated.

Mentions: Operations were performed under topical and local anesthetic. Upon surgical preparation, a modified Elsahy incision was designed over inverted nipple. The modification was such that the triangular flaps had wider bases (each ¼ of the circumference of nipple base) with flap lengths equal to the nipple diameter (Fig 1). The nipple was pulled anteriorly with a 5–0 nylon stay suture, and the nipple base was circumferentially incised to the superficial dermis.


Correction of Inverted Nipple Using Subcutaneous Turn-Over Flaps to Create a Tent Suspension-Like Effect.

Jeong HS, Lee HK - PLoS ONE (2015)

A schematic diagram of the design of the method for inverted nipple correction.Full-thickness subcutaneous triangular flaps are designed as shown in the diagram after pulling out the inverted nipple. The red dotted circle means the base of the nipple before traction. B’ is the dermal point of approximation of D and D’ from the areola, and A’ is the dermal point of approximation of C and C’ from the areola. After traction of the inverted nipple, the circular area of the nipple base becomes larger. The long axis of the triangular flap is equal to the diameter of the nipple base (BB’ = B’A’ = A’A). The tip of the triangular flap, or A, is overturned and fixated to B’, which is the dermal point to which D and D’ of the areola are approximated. The tip of the opposite triangular flap, B, is then fixated to A’, to which C and C’ are approximated.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4514896&req=5

pone.0133588.g001: A schematic diagram of the design of the method for inverted nipple correction.Full-thickness subcutaneous triangular flaps are designed as shown in the diagram after pulling out the inverted nipple. The red dotted circle means the base of the nipple before traction. B’ is the dermal point of approximation of D and D’ from the areola, and A’ is the dermal point of approximation of C and C’ from the areola. After traction of the inverted nipple, the circular area of the nipple base becomes larger. The long axis of the triangular flap is equal to the diameter of the nipple base (BB’ = B’A’ = A’A). The tip of the triangular flap, or A, is overturned and fixated to B’, which is the dermal point to which D and D’ of the areola are approximated. The tip of the opposite triangular flap, B, is then fixated to A’, to which C and C’ are approximated.
Mentions: Operations were performed under topical and local anesthetic. Upon surgical preparation, a modified Elsahy incision was designed over inverted nipple. The modification was such that the triangular flaps had wider bases (each ¼ of the circumference of nipple base) with flap lengths equal to the nipple diameter (Fig 1). The nipple was pulled anteriorly with a 5–0 nylon stay suture, and the nipple base was circumferentially incised to the superficial dermis.

Bottom Line: Many techniques have been reported for the correction of inverted nipples.A single-institutional retrospective review was performed for all patients who received the modified operation.Surgical details are described within the main text.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic & Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Republic of Korea.

ABSTRACT

Background: Many techniques have been reported for the correction of inverted nipples. However, the conventional methods may be insufficient, especially for moderate to severe inversions. We propose a modification of Elsahy's method and report satisfactory results.

Methods: A single-institutional retrospective review was performed for all patients who received the modified operation. Patient charts were reviewed for demographic data, pertinent preoperative factors such as Han and Hong classification, and clinical outcomes including postoperative nipple height and sensation. Surgical details are described within the main text.

Results: The review identified 26 female patients amongst whom 47 inverted nipples were corrected using the modified method. The mean nipple height was 9 mm with an average follow-up period of 14 months. Brush stimulation elicited nipple contraction in all patients. There was no recurrence of nipple inversion, nor were there any surgical complications to report.

Conclusion: The suspension technique is a simple, reliable method for correcting grade II and III nipple inversions.

No MeSH data available.


Related in: MedlinePlus