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J Cosmet Med 2018; 2(2): 91-95

Published online December 31, 2018

https://doi.org/10.25056/JCM.2018.2.2.91

Correction of inverted nipple with tongue-like dermal flaps near the junction of nipple and areola

Chen Zhang, MD, PhD1 , Chunying Ge, MD2, Changyuan Gao, MS1

1Institute of Plastic Surgery, Dalian University, Dalian, China, 2NY Fashion Clinic, Dalian, China

Correspondence to :
Chen Zhang, E-mail: neilzhang@sina.com, ORCID: https://orcid.org/0000-0002-4637-9357

Received: August 30, 2018; Accepted: October 17, 2018

© Korean Society of Korean Cosmetic Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Areolar dermal flaps are common and effective corrective means used in surgical treatment. However, in some patients, the areolar area may be too small to provide enough dermal tissue flaps. Therefore, we designed tongue-like dermal flaps near the junctional area of the nipple and areola.
Objective: To present a method for congenital inverted nipple repair with a low rate of recurrence.
Methods: From January 2014 to December 2017, 50 congenital inverted nipples were surgically treated in 29 women. The women were between 18 to 36 years of age with an average age of 23.6 years. Based on the Han and Hong classification, we developed a new 3-grade classification system for inverted nipples according to clinical manifestations. Based on our classification system, 39 nipples were grade II and 11 nipples were grade III. In all cases, tongue-like dermal flaps near the junctional area of the nipple and areola were designed and used to reposition the nipple. Purse-string sutures and removal of the mons on the surface of the nipple were supplementary means used to reduce the complication rate.
Results: All patients were followed up for 3 to 6 months postoperatively with an average follow-up period of 3.8 months. No major complications such as infection, numbness or nipple necrosis were encountered. In 1 case, the purse-string suture wore out part of the skin over it 5 weeks post-operation. The wound healed 1 week after thread removal and dressing change. There was no recurrence in the follow-up period. The scars on the nipples were almost invisible in all cases. All patients were satisfied with the nipple appearance after the procedure.
Conclusion: Tongue-like dermal flaps near the junctional area of the nipple and areola is a safe and effective method for the correction of inverted nipples.

Keywords: classification, dermal flap, inverted nipple, plastic surgery

  1. Hernandez Yenty QM, Jurgens WJ, van Zuijlen PP, de Vet HC, Verhaegen PD. Treatment of the benign inverted nipple: a systematic review and recommendations for future therapy. Breast 2016;29:82-9.
    Pubmed CrossRef
  2. Kim DY, Jeong EC, Eo SR, Kim KS, Lee SY, Cho BH. Correction of inverted nipple: an alternative method using two triangular areolar dermal flaps. Ann Plast Surg 2003;51:636-40.
    Pubmed CrossRef
  3. Burm JS, Kim YW. Correction of inverted nipples by strong suspension with areola-based dermal flaps. Plast Reconstr Surg 2007;120:1483-6.
    Pubmed CrossRef
  4. Pereira OJ, Bins-Ely J, Granemann AS, Lee KH. Correction of inverted nipples by strong suspension with areola-based dermal flaps. Plast Reconstr Surg 2009;123:1132; author reply 1132-3.
    Pubmed CrossRef
  5. Zhou H, Tan Q, Wu J, Zheng DF, Zhou HR, Xu P, et al. Correction of inverted nipple with bilateral areolar rhomboid dermal flaps. J Plast Reconstr Aesthet Surg 2011;64:e159-61.
    Pubmed CrossRef
  6. McG Taylor D, Lahiri A, Laitung JK. Correction of the severely inverted nipple: areola- based dermoglandular rhomboid advancement. J Plast Reconstr Aesthet Surg 2011;64:e297-302.
    Pubmed CrossRef
  7. Durgun M, Ozakpinar HR, Selçuk CT, Sarici M, Ceran C, Seven E. Inverted nipple correction with dermal flaps and traction. Aesthetic Plast Surg 2014;38:533-9.
    Pubmed CrossRef
  8. Han S, Hong YG. The inverted nipple: its grading and surgical correction. Plast Reconstr Surg 1999;104:389-95; discussion 396-7.
    Pubmed CrossRef
  9. Park HS, Yoon CH, Kim HJ. The prevalence of congenital inverted nipple. Aesthetic Plast Surg 1999;23:144-6.
    Pubmed CrossRef
  10. Sanuki J, Fukuma E, Uchida Y. Morphologic study of nipple-areola complex in 600 breasts. Aesthetic Plast Surg 2009;33:295-7.
    Pubmed CrossRef
  11. Mu D, Luan J, Mu L, Xin M. A minimally invasive gradual traction technique for inverted nipple correction. Aesthetic Plast Surg 2012;36:1151-4.
    Pubmed CrossRef
  12. Yukun L, Ke G, Jiaming S. Application of nipple retractor for correction of nipple inversion: a 10-year experience. Aesthetic Plast Surg 2016;40:707-15.
    Pubmed CrossRef

Article

Original Article

J Cosmet Med 2018; 2(2): 91-95

Published online December 31, 2018 https://doi.org/10.25056/JCM.2018.2.2.91

Copyright © Korean Society of Korean Cosmetic Surgery.

Correction of inverted nipple with tongue-like dermal flaps near the junction of nipple and areola

Chen Zhang, MD, PhD1 , Chunying Ge, MD2, Changyuan Gao, MS1

1Institute of Plastic Surgery, Dalian University, Dalian, China, 2NY Fashion Clinic, Dalian, China

Correspondence to:Chen Zhang, E-mail: neilzhang@sina.com, ORCID: https://orcid.org/0000-0002-4637-9357

Received: August 30, 2018; Accepted: October 17, 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Areolar dermal flaps are common and effective corrective means used in surgical treatment. However, in some patients, the areolar area may be too small to provide enough dermal tissue flaps. Therefore, we designed tongue-like dermal flaps near the junctional area of the nipple and areola.
Objective: To present a method for congenital inverted nipple repair with a low rate of recurrence.
Methods: From January 2014 to December 2017, 50 congenital inverted nipples were surgically treated in 29 women. The women were between 18 to 36 years of age with an average age of 23.6 years. Based on the Han and Hong classification, we developed a new 3-grade classification system for inverted nipples according to clinical manifestations. Based on our classification system, 39 nipples were grade II and 11 nipples were grade III. In all cases, tongue-like dermal flaps near the junctional area of the nipple and areola were designed and used to reposition the nipple. Purse-string sutures and removal of the mons on the surface of the nipple were supplementary means used to reduce the complication rate.
Results: All patients were followed up for 3 to 6 months postoperatively with an average follow-up period of 3.8 months. No major complications such as infection, numbness or nipple necrosis were encountered. In 1 case, the purse-string suture wore out part of the skin over it 5 weeks post-operation. The wound healed 1 week after thread removal and dressing change. There was no recurrence in the follow-up period. The scars on the nipples were almost invisible in all cases. All patients were satisfied with the nipple appearance after the procedure.
Conclusion: Tongue-like dermal flaps near the junctional area of the nipple and areola is a safe and effective method for the correction of inverted nipples.

Keywords: classification, dermal flap, inverted nipple, plastic surgery

References

  1. Hernandez Yenty QM, Jurgens WJ, van Zuijlen PP, de Vet HC, Verhaegen PD. Treatment of the benign inverted nipple: a systematic review and recommendations for future therapy. Breast 2016;29:82-9.
    Pubmed CrossRef
  2. Kim DY, Jeong EC, Eo SR, Kim KS, Lee SY, Cho BH. Correction of inverted nipple: an alternative method using two triangular areolar dermal flaps. Ann Plast Surg 2003;51:636-40.
    Pubmed CrossRef
  3. Burm JS, Kim YW. Correction of inverted nipples by strong suspension with areola-based dermal flaps. Plast Reconstr Surg 2007;120:1483-6.
    Pubmed CrossRef
  4. Pereira OJ, Bins-Ely J, Granemann AS, Lee KH. Correction of inverted nipples by strong suspension with areola-based dermal flaps. Plast Reconstr Surg 2009;123:1132; author reply 1132-3.
    Pubmed CrossRef
  5. Zhou H, Tan Q, Wu J, Zheng DF, Zhou HR, Xu P, et al. Correction of inverted nipple with bilateral areolar rhomboid dermal flaps. J Plast Reconstr Aesthet Surg 2011;64:e159-61.
    Pubmed CrossRef
  6. McG Taylor D, Lahiri A, Laitung JK. Correction of the severely inverted nipple: areola- based dermoglandular rhomboid advancement. J Plast Reconstr Aesthet Surg 2011;64:e297-302.
    Pubmed CrossRef
  7. Durgun M, Ozakpinar HR, Selçuk CT, Sarici M, Ceran C, Seven E. Inverted nipple correction with dermal flaps and traction. Aesthetic Plast Surg 2014;38:533-9.
    Pubmed CrossRef
  8. Han S, Hong YG. The inverted nipple: its grading and surgical correction. Plast Reconstr Surg 1999;104:389-95; discussion 396-7.
    Pubmed CrossRef
  9. Park HS, Yoon CH, Kim HJ. The prevalence of congenital inverted nipple. Aesthetic Plast Surg 1999;23:144-6.
    Pubmed CrossRef
  10. Sanuki J, Fukuma E, Uchida Y. Morphologic study of nipple-areola complex in 600 breasts. Aesthetic Plast Surg 2009;33:295-7.
    Pubmed CrossRef
  11. Mu D, Luan J, Mu L, Xin M. A minimally invasive gradual traction technique for inverted nipple correction. Aesthetic Plast Surg 2012;36:1151-4.
    Pubmed CrossRef
  12. Yukun L, Ke G, Jiaming S. Application of nipple retractor for correction of nipple inversion: a 10-year experience. Aesthetic Plast Surg 2016;40:707-15.
    Pubmed CrossRef

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