The Correction of Severe Inverted Nipple: Using Under Skin Dermal Flaps, Through-and-Through Suture and Purse-String Sutures.

Yoon, Sang Yub; Kang, Min Gu

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2009;36(3):322-326.
Published online May 1, 2009.

The Correction of Severe Inverted Nipple: Using Under Skin Dermal Flaps, Through-and-Through Suture and Purse-String Sutures.

Sang Yub Yoon, Min Gu Kang

Silhouette Clinic Center for Breast and Body Contouring, Seoul, Korea. pssurgeon@korea.com

Abstract

PURPOSE
Severe type of inverted nipple (cannot be pulled out above the areola plane by manipulation, grade III) usually cannot be corrected by a relatively simple pursestring suture technique. Most patients want to avoid visible scars. To treat the severe case and avoid visible stigma, we introduce this invisible dermal flap method. METHODS: This new surgical procedure makes bilateral incisions on the sidewall of nipple and dissections vertically to free the ducts from the contracted tissues. After dissection, the tunnel is formed. We insert "dermal flaps" into the tunnel underneath nipple base. Then through-and-through sutures are performed vertically (6 o'clock and 12 o'clock positions) and the purse-string suture is added with 4-0 nylon.
RESULTS
We had treated 35 primary inverted nipples (grade III) in 27 patients and 13 recurrent nipples in 7 cases. The results were excellent in 45 nipples (93.7%). All but 3 recurred cases was fully or very satisfied with the results.
CONCLUSION
This technique is effective for the correction of severe inverted nipples and recurrent cases. We can avoid the visible scars on the areola surface

Keywords: Inverted nipple; Dermal flap; Purse-string suture; Through-and-through suture