The Assessment And Correction Of Inverted Nipple With The Unequal Z Plasty And The Dermis Flaps

Objective:The purpose of this study is to investigate and assess an effective method to correct inverted nipple.Methods:Sixteen female patients (27 inverted nipples) with ages ranging from 20 to 39, consecutively, with nipple inversion deformity between January of 2000 and December of 2009 were included in this study. All of them have received the correction of inverted nipple. According to the factor of inverted nipple,two unequal Z plasty were designed in the areola and two dermis flaps were designed beside the skin flaps. After the nipple was elevated by releasing the fibrous tissue between depressed nipple and its base ,the dermis flaps were placed into the base of the nipple to support the inverted nipples, and the unequal Z flaps were rotated to form the neck of nipple.Then the neck was heightened and the base was tightened to reinforce the protrusion of the nipple and prevent the recurrence of the nipple inversion . After the operation , continuous traction of the nipple lasted one weeks at least. The assessments and follow-up were given at postoperative 1 month and 6 month to assess the operation technique.Results:All the patients who received the above technique have a good result without infection, necrosis and visible scar. No recurrence of the nipple inversion were found in all the cases. Follow-up and assessment at postoperative 1 months and 6 months showed that the shape and projection of the nipple was satisfactory. The average adjusted height of inverted nipple (â–³H ) at postoper- ative 1 months was 0.33cm. The shape assessment of 13 cases showed well (81.25%), 3 cases were general (18.75%) at postoperative 6 months . The sense assessment of 23 nipples showed well (85.19%), 4 nipples were general (14.81%)at postoperative 6 months. The erection of 26 nipples existed at postoperative 6 months, but the erection of 1 nipples did not examined at postoperative 6 months.Conclusions:1. The design of surgical operation which according to the factor of inverted nipple is an effective and practical surgical procedure for correction of nipple inversion. The unequal Z flaps were rotated to form the neck of nipple. The dermis flaps were placed into the base of the areola to support the inverted nipples. Nipple dermal flaps which attached to the support the nipple effectively and strongly,and reduce recurrence of inversion. Then the neck was heightened and the base was tightened to reinforce the protrusion of the nipple and prevent the recurrence of the nipple inversion .2. The design of surgical operation were individualized according to various appearances of nipple and areola. The symmetry of two sides nipples and nipple itself , also the agreement of nipple and areola ,were considered in the design of surgical operation.The design of surgical operation is scientific and reasonable ,which according to actual situation to adjust the width and place of Z plasty.3. It is clever to design the dermis flaps beside the unequal Z plasty . Only two scars are remained on the areola postoperatively.The scars are invisible.4. It is the first time to assess the operation result ,which including the adjusted height, the shape, the sense and the erection of inverted nipple postoperatively. The assessments show that this surgical operation which according to the factor of inverted nipple is an effective and practical surgical procedure for correction of nipple inversion.