A New Simple Technique to Correct Nipple Inversion Using 2 V-Y Advancement Flaps

Abstract

Nipple inversion is a particular condition characterized by shorter galactophorous ducts, periductal fibrosis, and lack of soft tissue under the nipple base. It can be congenital or acquired, and it affects about 10% of the female population. Many operative techniques have been described seeking to correct this deformity, but a unique landmark strategy does not exist yet. Although acceptable results have been reported, every surgical technique has its drawbacks. We describe our 5 years' experience in correcting inverted nipples by using a simple personal approach. Between January 2004 and January 2009, we treated 52 patients presenting with nipple inversion using 2 V-Y dermoglandular flaps performed in the dermoglandular portion of the nipple. This method is effective in the correction of moderate and severe inverted nipple deformities. Follow-up period ranged from 1 to 6 years. Results showed recurrence in 1 case and postoperative complications in 3 patients. The authors have found this to be an ideal procedure for correcting inverted nipple; the use of an easy to perform V-Y flap ensures nipple protrusion and support, lactation, and minimal scars.

Surgical Correction of Inverted Nipples

“…Techniques with lactiferous ducts preservation were divided into 3 subcategories based on the use of dermal flaps, sutures, or distractor systems. Fifteen studies described the use of dermal flaps (Table 3 5 , 8 - 9 , 11 , 14 , 17 , 21 , 24 , 26 , 28 , 30 , 32 , 34 , 35 , 40 ) with triangular, rhomboid, longitudinal, elliptical, or “diamond” shapes (Fig. 3 ).…”

“…Eleven authors explicitly described the placement of a temporary traction (3–30 days) 19 , 33 , 34 , 41 or a “donut” dressing to avoid a postoperative compression (2 weeks–6 months). 14 , 15 , 21 , 24 , 28 , 29 …”

Nipple ulcers of the nipple retractor technique to correct inverted nipples: A retrospective multivariate analysis

“…13 Various open surgical procedures have been adopted to achieve a satisfactory clinical outcome, including continuous external eversion of the nipple, the release of the retracting lactiferous ducts and fibrous bands, the addition of supportive bulk at the nipple base, and the tightening of the nipple neck. 1,6,14 However, these procedures are not simple and may change the shape of the nipple and breast, increasing the risk of complications and affecting breastfeeding and nipple sensitivity. 1 Theory of Ilizarov believes continuous stress could stimulate and maintain tissue regeneration, based on which, a convenient method using a nipple retractor to correct inverted nipples was first proposed by Ru Zhao.…”

A Minimally Invasive Gradual Traction Technique for Inverted Nipple Correction

“…To date, various surgical procedures have been developed to correct an inverted nipple [1][2][3]. Most of these techniques are open surgical procedures that involve cutting and releasing of the hypoplastic lactiferous ducts, which certainly will have a negative impact on breastfeeding [4,5].…”