Correction of the Inverted Nipple With an Internal 5-Point Star Suture

Abstract

To date, many of the methods reported for the surgical treatment of the inverted nipple include insertion of autologous or heterologous material to provide volume and projection to the nipple, thereby avoiding recurrence. In cases of severely inverted nipple with severe fibrosis and shortening of the lactiferous ducts, the authors' technique combines the pulling out of the nipple and the release of the fibrosis and retracting ducts with the introduction of a stitch of polyglactin as filling material, performing an internal star suture in only one surgical intervention, without the need for using graft material, or local flaps that introduce scars around the nipple. The technique is simple, with excellent and long-lasting results.

Correction of Inverted Nipple: Comparison of Techniques with Novel Approaches

“…Various procedures have been proposed for the repair of inverted nipple since it was first described (Alaxander & Campbell, 1997;Kim et al, 2006;Serra-Renom et. Al, 2004;Jiang et al, 2008;Yamada et al, 2004;Ritz et al, 2005;Huang , 2003;Crestinu, 2001;Pompei & Tedesco, 1999).…”

“…No single technique is appropriate for correcting all the types of nipple deformities because different grades of inverted nipple have different levels of fibrosis, soft tissue bulk, and lactiferous ductus stucture . Some of the techniques include construction at the base of the nipple by using areolar dermal flaps (Kim et al, 2003;Kim et al, 2006;Huang 2003) modified suturing ''t'' (Stevens et al, 2004;Serra-Renom, 2004) or a combination of these two (Pompei & Tedesco, 1999) to prevent the collapse of the nipple. Other techniques use alloplastic materials, i.e., silicone or PTFE, where extrusion is a potential complication; they have their own limitations (Serra-Renom, 2004).…”

“…Numerous techniques have been reported to correct the inverted nipple (Alaxander & Campbell, 1997;Kim et al, 2006;Serra-Renom et. Al, 2004;Jiang et al, 2008;Yamada et al, 2004;Ritz et al, 2005;Huang , 2003;Crestinu, 2001;Pompei & Tedesco, 1999) It was also reported that no single technique is appropriate for correcting all types of nipple deformities because different grades of inverted nipple have different levels of fibrosis, soft tissue bulk, and lactiferous ductus stucture .…”

Inverted Nipple Correction Using a Combination of the Perpendicular Suture Method and the Purse-String Suture Method

“…Surgical techniques to correct inverted nipples have been studied, and various methods have been suggested, such as dermal and dermoglandular flaps, endoscopic release, internal suturing, continuous traction, and the use of artificial dermis [3][4][5][6][7][8]10]. Techniques using sutures have the advantage of reducing incisions and scarring, and are also considered safe.…”

Correction of Inverted Nipple with “Arabesque”-Shape Sutures

“…Many different surgical techniques to correct inverted nipple have been described such as dermal and dermoglandular flaps, endoscopic release, internal suture, continuous traction, and artificial dermis, suggesting that no technique is totally successful [4][5][6][7][8][9][10]. The diversity of procedures denotes the lack of a single technique that reliably results in durable, sustainable correction for this common problem.…”