Kim Tae Hyung, Wee Syeo Young
Department of Plastic and Reconstructive Surgery, Soonchunhyang University Gumi Hospital, 1 Gongdan-ro 179, Gumi-si, Gyeonsangbuk-do, 39371, Republic of Korea.
Aesthetic Plast Surg. 2023 Jun;47(3):998-1006. doi: 10.1007/s00266-022-03216-8. Epub 2023 Jan 19.
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.
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.
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.
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.
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乳头内陷患者会经历各种不适并发症，包括反复感染。关于乳头内陷的严重程度，高于II级（按照Han和Hong的分类）的乳头内陷需要手术矫正。已经提出了许多治疗乳头内陷的方法。然而，即使经过治疗，复发一直是个问题。因此，我们提出一种使用带脱细胞真皮基质的菱形皮瓣治疗乳头内陷的新方法。
在2019年3月至2022年2月期间，本研究共纳入了5例III级乳头内陷患者。在乳头的3点和9点位置设计两个菱形皮瓣。掀起该皮瓣并在乳头基部围绕乳头柱进行包裹。对女性患者的输乳管全部进行了切断。此外，插入脱细胞真皮基质以填充乳头基部的死腔。在术后6个月、12个月进行乳头高度和瘢痕评估。在最后一次随访时还检查了总体满意度和并发症情况。
乳头内陷得到矫正，未报告血肿、感染和坏死等并发症。乳头突出得以维持，无任何复发，中位数略有下降1.5毫米（减少20%）。除了一些小瘢痕外，未发现任何大小并发症，患者在随访期间对美学效果满意。
这是一种用于乳头内陷手术矫正的快速且简单的技术。使用脱细胞真皮基质，安全地维持了乳头突出和悬吊，无并发症发生。该技术可作为重度乳头内陷手术治疗的一种选择。
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