Skip to main content

Advertisement

SpringerLink
Log in

A New Method for Inverted Nipple Treatment with Diamond-Shaped Dermal Flaps and Acellular Dermal Matrix: A Preliminary Study

  • Original Article
  • Breast Surgery
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

A Correction to this article was published on 08 March 2023

This article has been updated

Abstract

Background

Patients with inverted nipples experience various uncomfortable complications including recurrent infections. Regarding the level of severity of inverted nipple, those that are higher than grade II (as classified by Han and Hong) requires surgical correction. Many methods have been proposed to treat the inverted nipple. However, even after treatment, recurrence has always posed a problem. Thus, we propose a new method using the diamond-shaped dermal flap with acellular dermal matrix to treat the inverted nipple.

Method

Between March 2019 and February 2022, a total of five patients with grade III were studied in this study. Two diamond-shaped flaps were designed at the 3 and 9 o’clock positions of the nipple. This dermal flap was elevated and wrapped around the nipple column at the nipple base. The lactiferous ducts in female were all divided. In addition, acellular dermal matrix was inserted to fill the dead space of the nipple base. The nipple height and scar evaluation were conducted on 6 month, 12 month postoperatively. Overall satisfaction and complications were also checked at the last visit.

Results

The inverted nipple was resolved and no complications such as hematoma, infection, and necrosis were reported. The projection was maintained without any recurrence, with a slight decrease of 1.5 mm (reduction in 20%) in median value. There were no major or minor complications found except for a few small scars, and the patient was satisfied with the esthetic outcomes during the follow-up.

Conclusion

This is a fast and simple technique for the surgical correction of inverted nipples. Using the acellular dermal matrix, projection and suspension were safely maintained without complications. This technique could be an option for the surgical treatment of severe types of inverted nipples.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors  www.springer.com/00266.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5.

Similar content being viewed by others

Change history

References

  1. Han S, Hong YG (1999) The inverted nipple: its grading and surgical correction. Plast Reconstr Surg 104(2):389–395

    Article  CAS  PubMed  Google Scholar 

  2. Bracaglia R, Tambasco D, Gentileschi S, D’Ettorre M (2012) Recurrent inverted nipple: a reliable technique for the most difficult cases. Ann Plast Surg 69(1):24–26

    Article  CAS  PubMed  Google Scholar 

  3. Tan YY, Chin YR, Bajaj K, Thomas S (2021) Patient-reported outcomes for nipple reconstruction: review of literature. Surgeon 19(5):e245–e255

    Article  PubMed  Google Scholar 

  4. Park JH, Wee SY, Jeong HG, Choi CY (2017) A novel lactiferous duct preserving method for inverted nipples: an inlay wrap-around flaps supporting the nipple column. Arch Aesthetic Plast Surg 23(1):45–48

    Article  Google Scholar 

  5. Kolker AR, Torina PJ (2009) Minimally invasive correction of inverted nipples: a safe and simple technique for reliable, sustainable projection. Ann Plast Surg 62(5):549–553

    Article  CAS  PubMed  Google Scholar 

  6. Yukun L, Ke G, Juaming S (2016) Application of nipple retractor for correction of nipple inversion: a 10-year experience. Aesthetic Plast Surg 40(5):707–715

    Article  PubMed  Google Scholar 

  7. Elsahy NI (1976) An alternative operation for inverted nipple. Plast Reconstr Surg 57(4):438–491

    Article  CAS  PubMed  Google Scholar 

  8. Kim DY, Jeong EC, Eo SR, Kim KS, Lee SY, Cho BH (2003) Correction of inverted nipple: an alternative method using two triangular areolar dermal flaps. Ann Plast Surg 51(6):636–640

    Article  PubMed  Google Scholar 

  9. Huang WC (2003) A new method for correction of inverted nipple with three periductal dermofibrous flaps. Aesthetic Plast Surg 27(4):301–304

    Article  PubMed  Google Scholar 

  10. Zhang Q, Yang C (2004) Correction of congenital nipple inversion with bilateral rhombus deepithelialized subcutaneous pedicle skin flaps and continuous traction. Zhonghua Zheng Xing Wai Ke Za Zhi 20(1):21–23

    PubMed  Google Scholar 

  11. Ritz M, Silfen R, Morgan D, Southwick G (2005) Simple technique for inverted nipple correction. Aesthetic Plast Surg 29(1):24–27

    Article  PubMed  Google Scholar 

  12. Wu HL, Huang X, Zheng SS (2008) A new procedure for correction of severe inverted nipple with two triangular areolar dermofibrous flaps. Aesthetic Plast Surg 32(4):641–644

    Article  CAS  PubMed  Google Scholar 

  13. Min KH, Park SS, Heo CY, Min KW (2010) Scar-free technique for inverted-nipple correction. Aesthetic Plast Surg 34(1):116–119

    Article  PubMed  Google Scholar 

  14. Tuncel U, Gümüş M, Turan A, Uyanık D, Olgun E, Kostakoğlu N (2014) Alternative nipple suspension technique in the treatment of inverted nipple: reverse s-shaped design. J Cutan Aesthet Surg 7(4):220–223

    Article  PubMed  PubMed Central  Google Scholar 

  15. Brent B, Bostwick J (1977) Nipple-areola reconstruction with auricular tissues. Plast Reconstr Surg 60(3):353–361

    CAS  PubMed  Google Scholar 

  16. Dessena L, Dast S, Perez S, Mercut R, Herlin C, Sinna R (2008) Inverted nipple treatment and poliglecaprone spacer. Aesthetic Plast Surg 42(4):958–963

    Article  Google Scholar 

  17. Long X, Zhao R (2011) Nipple retractor to correct inverted nipples. Breast Care Basel 6(6):463e5

    Google Scholar 

  18. Gould DJ, Nadeau MH, Macias LH, Stevens WG (2015) Inverted nipple repair revisited: a 7-year experience. Aesthet Surg J 35(2):156–164

    Article  PubMed  Google Scholar 

  19. Jeong HS, Lee HK (2015) Correction of inverted nipple using subcutaneous turn-over flaps to create a tent suspension-like effect. PLoS ONE 10(7):e0133588

    Article  PubMed  PubMed Central  Google Scholar 

  20. Mathur B, Loh CYY (2019) Sensation-sparing correction of inverted nipples using the ‘drawbridge’ flap approach. Aesthetic Plast Surg 43(2):348–353

    Article  PubMed  Google Scholar 

  21. Kim JT, Lim YS, Oh JG (2006) Correction of inverted nipples with twisting and locking principles. Plast Reconstr Surg 118(7):1526–1531

    Article  CAS  PubMed  Google Scholar 

  22. Durgun M, Ozakpinar HR, Selçuk CT, Sarici M, Ceran C, Seven E (2014) Inverted nipple correction with dermal flaps and traction. Aesthetic Plast Surg 38(3):533–539

    Article  PubMed  Google Scholar 

  23. Townsend PL (1974) Nipple sensation following breast reduction and free nipple transplantation. Brit J Plast Surg 27:308–310

    Article  CAS  PubMed  Google Scholar 

  24. Longo B, Campanale A, Farcomeni A, Santanelli F (2013) Long-term sensory recovery of nipple-areola complex following superolateral pedicled reduction mammaplasty. Plast Reconstruct Surg 132:735–742

    Article  Google Scholar 

Download references

Funding

This work was supported in part by the Soonchunhyang University Research Fund.

Author information

Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Soonchunhyang University Gumi Hospital, 1 Gongdan-ro 179, Gumi-si, Gyeonsangbuk-do, 39371, Republic of Korea

    Tae Hyung Kim & Syeo Young Wee

Authors
  1. Tae Hyung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Syeo Young Wee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Syeo Young Wee.

Ethics declarations

Conflict of interest

The authors have no potential conflict of interest relevant to this article to report.

Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Institutional Review Board (IRB No. 2021-01). For this type of study, informed consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article was updated. The third to last sentence in the section “Operative Technique” was corrected to read: Point A was fixated to D' on the opposite side and point B was fixated to C', also C to B' and D to A'.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, T.H., Wee, S.Y. A New Method for Inverted Nipple Treatment with Diamond-Shaped Dermal Flaps and Acellular Dermal Matrix: A Preliminary Study. Aesth Plast Surg 47, 998–1006 (2023). https://doi.org/10.1007/s00266-022-03216-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-022-03216-8

Keywords

Search

Navigation