Subareolar Dermofibrous Flaps for Correction of Inverted Nipple

Abstract
Background: Inverted nipple is a nipple located on a plane lower than the areola, presents both functional and cosmetic problems. It is a source of repeated irritation and inflammation interferes with nursing and may cause psychologic distress.
Many operative modalities are available for correction; they range from suture based methods to the use of areolar or nipple dermal flaps. This variety of available methods amply reflects the difficulty of achieving a satisfactory out-come. In this study a new technique is adopted, based on the use of two triangular subareolar dermofibrous flaps.
Aim: The aim of this study was to assess the use of subareolar dermofibrous flaps for correction of inverted nipple in term of shape and recurrence.
Methods: The study was carried out on 15 inverted nipples in 10 female patients. Every case was subjected to the follow-ing: Full history taking, clinical examination including general, breast, axilla, nipple and areola examination. The investigations conducted included laboratory work up and breast mammog-raphy with complementary ultrasonography.
Results: The follow-up period after removal of distracter ranged from 6 months to 1 year. During the follow-up period, patient satisfaction was assessed. Good aesthetic results were achieved for 80% of patients who were very satisfied with the outcome while 20% were not satisfied because of recur-rence. Infection occurred in only 1 patient in the immediate post-operative period that resolved after antibiotic adminis-tration. No complications such as pain, temporary sensory disturbance, skin pigmentation or nipple necrosis were recorded in this study.
Conclusions: The described technique is easy, reliable and does not leave visible scars on areolar skin. In particular, it has been found to be effective for treating grade 2 and 3 inverted nipples.