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Aesthetic Plastic Surgery

, Volume 43, Issue 2, pp 348–353 | Cite as

Sensation-Sparing Correction of Inverted Nipples Using the ‘Drawbridge’ Flap Approach

  • Bhagwat MathurEmail author
  • Charles Yuen Yung LohEmail author
Innovative Techniques Breast Surgery

Abstract

Introduction

An inverted nipple can cause significant functional and psychologic disturbance to women. The holy grail of any surgical technique to correct this is to restore adequate nipple projection and at the same time, try to preserve lactation and nipple sensation. We describe our experience using an inferior dermal nipple-areolar interposition flap to correct the inverted nipple alongside with selective release of the lactiferous ducts of the nipple.

Materials and Methods

We have employed this technique successfully in 97 cases of inverted nipples in 60 patients with follow-up periods of up to 2 years. Twenty-three of them had unilateral inversion, and 37 of them had bilateral nipple inversion.

Results

The appearance of the nipple was good to excellent. Seventy to 80% of the initial postoperative nipple projection at the end of 1 year was maintained. Postoperative complications included stitch abscess in one patient (n = 1) and an epidermal cyst in another (n = 1). Nipple sensation was preserved in 100% of cases. There was no recurrence of inversion in any of the nipples.

Discussion

By identifying the root cause of inverted nipples in each individual case, and selectively targeting them, we minimize surgical morbidity with a simple technique that avoids any form of traction or compression of the nipple and minimizes the risk of altered nipple sensation.

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.

Keywords

Inverted nipple correction Dermal nipple areola flap Drawbridge flap approach Nipple flap Nipple reconstruction Dermal flap 

Notes

Acknowledgements

The authors acknowledge the work of Mrs. E M W Mithoff, Consultant Plastic Surgeon, Canniesburn Unit, Glasgow Royal Infirmary, Glasgow, UK. None of the authors have a financial interest in any of the products, devices or drugs mentioned in this manuscript.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  1. 1.St. Andrew’s Centre for Plastic Surgery and BurnsChelmsfordUK
  2. 2.St Andrew’s Centre for Plastic and Reconstructive SurgeryBroomfield HospitalChelmsfordUK
  3. 3.Center for Vascularized Composite Allotransplantation, Department of Plastic SurgeryChang Gung Memorial HospitalGueishan, TaoyuanTaiwan, ROC

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