Correction of inverted nipple using strut reinforcement with deepithelialized triangular flaps

Correcting Nipple Inversion Simultaneously with Implant Augmentation of the Breast, Using "Pirelli" Technique

Most techniques of isolated nipple inversion correction are well published. Simultaneous breast augmentation with nipple inversion correction is less often found in the literature. Previously, nipple inversion correction was thought to be performed as a staged procedure after other breast operations. We present a study of 19 patients and 34 breasts who had concomitant breast augmentation and nipple inversion correction treated with a “Pirelli” technique to assess the complication rates and the rate of recurrence of inversion.

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

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.

Correction of inverted nipple with "arabesque"-shape sutures

BACKGROUND

Inverted nipples are a common self-concern for many women and also a relatively aesthetic problem for the plastic surgeon.

METHODS

Many techniques for correcting inverted nipples have been reported, but none is totally successful. To avoid recurrence and to attain perfect shape of the nipple, the authors present a minimal-incision technique supported by "arabesque"-shape percutaneous sutures. First, four micro-incisions about 0.5 cm in size, each the circumference of the nipple, are designed horizontally. Second, after sufficient releasing of the loose connective tissue beneath the nipple, two 4/0 PDS sutures are made in perpendicular directions to increase the support and sustain the tissue under the nipple and to close the way the nipple inverts.

RESULTS

This method was used to correct 22 inverted nipples of 18 patients classified as grade 3 or 4. The entire nipple remained everted and symmetric during a follow-up period of 3 months to 1 year except in two cases of recurrence during the early postoperative period due to a loose knot.

CONCLUSION

The described technique is simple, safe, and reliable, providing sustained results over the long-term follow-up period with a high rate of stable eversion and patient satisfaction.

Correction of severely inverted nipple with telescope method

For female patients, an inverted nipple can result in functional problems, such as difficulty breast feeding, and emotional difficulties because of self-consciousness about the condition. Numerous surgical techniques for inverted nipple correction have been proposed, but none of the methods provides a reliable outcome. Most methods involve releasing retractile ducts and fibrous bands and adding bulk at the base of nipple; however, these techniques can cause injury to normal lactiferous ducts and sensory dysfunction. Herein we describe a "telescope method," performed under local anesthesia, which consists of making a circumferential incision, pulling out the nipple, and tightening the nipple base. With this technique, most lactiferous ducts and parallel sensory nerves that travel through the nipple base are not injured, and the procedure is associated with a less visible scar and nipple deformity than other methods. We report on 23 nipples of 17 patients that were successfully treated with this method. There was no recurrence of nipple inversion or sensory disturbance in the follow-up period. This technique is a simple, safe, and reliable method for the correction of severely inverted nipples.