The Endoscope as an Adjunct to Correction of Nipple Inversion Deformity

Abstract

Correction of the inverted nipple requires release of constricting fibrous tissue and suspension of the nipple. Despite the simplicity, lasting repair is often difficult to achieve, as is the ability to assure preservation of functioning lactiferous ducts during release. Since 2002, the authors have used the endoscope to guide selective division of retracted fibrous bands, followed by the use of a dermal fat graft and purse-string suture to the base to achieve stable nipple projection. In this series of 28 nipples of 15 patients, the patients were followed up for a mean period of 14 months (range, 6 to 26 months). The outcome was judged to be excellent in 23 nipples (82 percent) and fair in five (18 percent). There were no instances of any changes in sensitivity of the nipple-areola complex. Four patients experienced lactation afterward. The endoscope clearly delineated band from duct. The authors' technique was able to maintain excellent projection, with preservation of breast feeding as well as normal breast sensation, except in grade IIIB inverted nipples.