Inverted nipple correction with dermal flaps and traction.
BACKGROUND
Inverted nipple occurs when part of or the entire nipple is abnormally located below the areola. Surgical repair of severe cases involves suture or flap techniques. Complications include recurrence, lactation problems, hypopigmented scar formation in the areola, and loss of sensation. We describe an alternative repair technique using a dermal flap and traction, which leads to less apparent scarring and preserves lactation function and sensation.


METHODS
Between January 2010 and January 2013, we treated 28 inverted nipples in 16 patients using two areola-based triangular dermal flaps and traction. The scar was aligned with the junction of the nipple and the areola. Postoperatively, traction was applied through an apparatus prepared from a 50-cc syringe. Patients were followed up for 8-24 months (mean = 16.5 months).


RESULTS
Adequate projection was achieved in all patients and no wound dehiscence or complications such as infection occurred. Unilateral recurrence occurred in one patient on the 10th postoperative day. This patient was reoperated on successfully using the same method. No loss of sensation was observed in any of the patients during the postoperative period.


CONCLUSIONS
This dermal flap technique for treating inverted nipple was effective and preserved lactation function. The alignment of the scar with the junction of the nipple and the areola led to a more aesthetic appearance with no apparent scarring. The traction method helped maintain traction for a longer period, which in our opinion increased the success rate of the surgery.


METHODS
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Medical Faculty, Plastic Reconstructive and Aesthetic Surgery Department, Dicle University, Diyarbakır, 21280, Turkey, mustafadurgun@gmail.com.
Mustafa
M
Durgun
Hülda Rifat
HR
Ozakpinar
Caferi Tayyar
CT
Selçuk
Murat
M
Sarici
Candemir
C
Ceran
Ergin
E
Seven
D000293:Adolescent; D000328:Adult; D001941:Breast Diseases / Q000601:surgery; D002921:Cicatrix; D006801:Humans; D009558:Nipples / Q000002:abnormalities* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps; D014143:Traction; D055815:Young Adult